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ICD-10 Guide
ICD-10 CodesS12.55

S12.55

Billable

Other traumatic spondylolisthesis of sixth cervical vertebra

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

Code Description

ICD-10 S12.55 is a billable code used to indicate a diagnosis of other traumatic spondylolisthesis of sixth cervical vertebra.

Key Diagnostic Point:

S12.55 refers to a specific type of spinal injury characterized by the displacement of the sixth cervical vertebra (C6) due to trauma. This condition can occur as a result of high-impact injuries such as motor vehicle accidents, falls from heights, or sports-related injuries. The mechanism of injury typically involves a sudden force that causes the vertebra to slip forward or backward relative to the adjacent vertebrae, leading to instability in the cervical spine. Clinically, patients may present with neck pain, neurological deficits, or symptoms of spinal cord compression, such as weakness, numbness, or tingling in the upper extremities. Diagnosis is primarily made through imaging studies, including X-rays, CT scans, or MRI, which help visualize the degree of displacement and any associated injuries to the spinal cord or surrounding structures. Management may involve conservative treatment such as immobilization and physical therapy, or surgical intervention in cases of significant instability or neurological compromise. Complications can include chronic pain, persistent neurological deficits, or the development of post-traumatic arthritis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of specific anatomical terminology
  • Differentiation from other types of spondylolisthesis
  • Need for precise documentation of trauma mechanism
  • Potential for associated neurological injuries

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the level of vertebral involvement
  • Misclassification of the type of spondylolisthesis
  • Lack of imaging results in the medical record

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Documentation must include a detailed account of the mechanism of injury, initial assessment findings, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with acute neck pain following a fall or collision, requiring rapid assessment and imaging.

Billing Considerations

Ensure that all neurological assessments are documented, as they are critical for determining the severity of the injury.

Surgery

Documentation Requirements

Operative reports must detail the surgical approach, findings, and any corrective measures taken to stabilize the cervical spine.

Common Clinical Scenarios

Surgical intervention for significant displacement or neurological compromise following trauma.

Billing Considerations

Document any pre-existing conditions that may affect surgical outcomes or recovery.

Coding Guidelines

Inclusion Criteria

Use S12.55 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used in conjunction with appropriate external cause codes to capture the mechanism of injury

Exclusion Criteria

Do NOT use S12.55 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Anterior cervical discectomy and fusion

Clinical Scenario

Used in cases of significant spondylolisthesis requiring surgical intervention.

Documentation Requirements

Operative report must detail the procedure and rationale for surgery.

Specialty Considerations

Ensure that the surgical approach aligns with the diagnosis of traumatic spondylolisthesis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of traumatic injuries, including spondylolisthesis, which enhances the accuracy of patient records and facilitates better tracking of treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of traumatic injuries, including spondylolisthesis, which enhances the accuracy of patient records and facilitates better tracking of treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of traumatic injuries, including spondylolisthesis, which enhances the accuracy of patient records and facilitates better tracking of treatment outcomes.

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 primary cause of S12.55?

S12.55 is primarily caused by traumatic events such as falls, motor vehicle accidents, or sports injuries that lead to the displacement of the sixth cervical vertebra.