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ICD-10 Guide
ICD-10 CodesS12.601

S12.601

Billable

Unspecified nondisplaced fracture of seventh cervical vertebra

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

Code Description

ICD-10 S12.601 is a billable code used to indicate a diagnosis of unspecified nondisplaced fracture of seventh cervical vertebra.

Key Diagnostic Point:

The S12.601 code refers to an unspecified nondisplaced fracture of the seventh cervical vertebra (C7), which is located in the neck region. This type of fracture typically occurs due to trauma, such as falls, motor vehicle accidents, or sports injuries. Nondisplaced fractures mean that the bone has cracked but has not moved out of its normal alignment. Clinical presentation may include neck pain, limited range of motion, and neurological symptoms if the spinal cord is affected. Diagnosis is usually confirmed through imaging studies, such as X-rays or MRI, which help visualize the fracture and assess any potential complications. Management often involves conservative treatment, including 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. Understanding the mechanisms of injury and the clinical implications of a C7 fracture is crucial for accurate coding and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for precise documentation of injury mechanism
  • Differentiation from other cervical spine injuries
  • Potential for associated neurological deficits

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the type of fracture (nondisplaced vs. displaced)
  • Lack of imaging documentation to support the diagnosis
  • Inconsistent clinical findings reported 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 imaging results.

Common Clinical Scenarios

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

Billing Considerations

Ensure that all relevant imaging studies are documented and correlate with the clinical findings.

Surgery

Documentation Requirements

Operative reports must detail the surgical approach, findings, and any interventions performed.

Common Clinical Scenarios

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

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use S12.601 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code accurately reflects the clinical scenario and is supported by documentation
  • Use additional codes to specify any associated conditions or complications

Exclusion Criteria

Do NOT use S12.601 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Anterior cervical discectomy and fusion

Clinical Scenario

Used in cases where surgical intervention is required for stabilization of the cervical spine.

Documentation Requirements

Operative report must detail the procedure and indications.

Specialty Considerations

Ensure that the diagnosis supports the need for surgical intervention.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of cervical spine injuries, improving the accuracy of diagnosis and treatment tracking. S12.601 provides a clear designation for nondisplaced fractures, aiding in clinical management and billing.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cervical spine injuries, improving the accuracy of diagnosis and treatment tracking. S12.601 provides a clear designation for nondisplaced fractures, aiding in clinical management and billing.

Reimbursement & Billing Impact

billing.

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 significance of coding S12.601 accurately?

Accurate coding of S12.601 is crucial for proper reimbursement, tracking of injury trends, and ensuring appropriate patient management. It also helps in avoiding audit risks associated with unspecified codes.