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ICD-10 Guide
ICD-10 CodesS12.491

S12.491

Billable

Other nondisplaced fracture of fifth cervical vertebra

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 S12.491 is a billable code used to indicate a diagnosis of other nondisplaced fracture of fifth cervical vertebra.

Key Diagnostic Point:

The S12.491 code refers to a nondisplaced fracture of the fifth cervical vertebra (C5), which is a common injury resulting from trauma, such as falls, motor vehicle accidents, or sports injuries. Nondisplaced fractures occur when the bone cracks but maintains its proper alignment, which can lead to less severe symptoms compared to displaced fractures. Clinical presentation may include neck pain, limited range of motion, and neurological symptoms if the spinal cord is affected. Diagnosis typically involves imaging studies such as X-rays, CT scans, or MRIs to confirm the fracture and assess for any associated injuries. Management often includes conservative treatment like immobilization with a cervical collar, pain management, and physical therapy. In some cases, surgical intervention may be necessary if there are complications or if conservative treatment fails. Complications can include chronic pain, stiffness, or neurological deficits if the spinal cord is compromised.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between displaced and nondisplaced fractures
  • Understanding the specific cervical vertebra involved
  • Documenting associated neurological symptoms
  • Identifying the mechanism of injury

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of fracture (nondisplaced vs. displaced)
  • Missing neurological assessment findings
  • Incorrect linkage of external cause codes

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Complete documentation of the patient's presentation, mechanism of injury, and initial assessment findings.

Common Clinical Scenarios

Patients presenting with neck pain after a fall or motor vehicle accident.

Billing Considerations

Ensure that all relevant imaging results and neurological evaluations are documented.

Surgery

Documentation Requirements

Detailed operative reports if surgical intervention is performed, including preoperative and postoperative assessments.

Common Clinical Scenarios

Surgical management of cervical fractures due to instability or neurological compromise.

Billing Considerations

Document the rationale for surgical intervention and any complications encountered.

Coding Guidelines

Inclusion Criteria

Use S12.491 When
  • Follow the official ICD
  • CM guidelines for coding fractures, ensuring accurate documentation of the type of fracture and any associated injuries
  • External cause codes should be used to specify the mechanism of injury

Exclusion Criteria

Do NOT use S12.491 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Anterior cervical discectomy and fusion

Clinical Scenario

Used when surgical intervention is required for a cervical fracture.

Documentation Requirements

Operative report detailing the procedure and indications.

Specialty Considerations

Ensure that the diagnosis supports the need for surgery.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fractures, improving the granularity of data for research and treatment outcomes. S12.491 provides a clear distinction for nondisplaced fractures, which aids in appropriate management and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the granularity of data for research and treatment outcomes. S12.491 provides a clear distinction for nondisplaced fractures, which aids in appropriate management and reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between a displaced and nondisplaced fracture?

A displaced fracture involves a break in the bone where the ends are not aligned, while a nondisplaced fracture means the bone cracks but remains in its normal position.