2022 ICD-10-CM Code S12.0

Fracture of first cervical vertebra

Version 2021

Not Valid for Submission

ICD-10:S12.0
Short Description:Fracture of first cervical vertebra
Long Description:Fracture of first cervical vertebra

Code Classification

  • Injury, poisoning and certain other consequences of external causes (S00–T98)
    • Injuries to the neck (S10-S19)
      • Fracture of cervical vertebra and other parts of neck (S12)

S12.0 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of fracture of first cervical vertebra. The code is not specific and is NOT valid for the year 2022 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Coding Guidelines

The principles of multiple coding of injuries should be followed in coding fractures. Fractures of specified sites are coded individually by site nd the level of detail furnished by medical record content.

A fracture not indicated as open or closed should be coded to closed. A fracture not indicated whether displaced or not displaced should be coded to displaced.

Initial vs. Subsequent Encounter for Fractures

Traumatic fractures are coded using the appropriate 7th character for initial encounter (A, B, C) for each encounter where the patient is receiving active treatment for the fracture. The appropriate 7th character for initial encounter should also be assigned for a patient who delayed seeking treatment for the fracture or nonunion.

Fractures are coded using the appropriate 7th character for subsequent care for encounters after the patient has completed active treatment of the fracture and is receiving routine care for the fracture during the healing or recovery phase.

Care for complications of surgical treatment for fracture repairs during the healing or recovery phase should be coded with the appropriate complication codes.

Care of complications of fractures, such as malunion and nonunion, should be reported with the appropriate 7th character for subsequent care with nonunion (K, M, N,) or subsequent care with malunion (P, Q, R).

Malunion/nonunion: The appropriate 7th character for initial encounter should also be assigned for a patient who delayed seeking treatment for the fracture or nonunion.

The open fracture designations in the assignment of the 7th character for fractures of the forearm, femur and lower leg, including ankle are based on the Gustilo open fracture classification. When the Gustilo classification type is not specified for an open fracture, the 7th character for open fracture type I or II should be assigned (B, E, H, M, Q).

Specific Coding for Fracture of first cervical vertebra

Non-specific codes like S12.0 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for fracture of first cervical vertebra:

  • NON-BILLABLE CODE - S12.00 for Unspecified fracture of first cervical vertebra
  • NON-BILLABLE CODE - S12.000 for Unspecified displaced fracture of first cervical vertebra
  • BILLABLE CODE - Use S12.000A for initial encounter for closed fracture
  • BILLABLE CODE - Use S12.000B for initial encounter for open fracture
  • BILLABLE CODE - Use S12.000D for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S12.000G for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S12.000K for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S12.000S for sequela
  • NON-BILLABLE CODE - S12.001 for Unspecified nondisplaced fracture of first cervical vertebra
  • BILLABLE CODE - Use S12.001A for initial encounter for closed fracture
  • BILLABLE CODE - Use S12.001B for initial encounter for open fracture
  • BILLABLE CODE - Use S12.001D for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S12.001G for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S12.001K for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S12.001S for sequela
  • NON-BILLABLE CODE - S12.01 for Stable burst fracture of first cervical vertebra
  • BILLABLE CODE - Use S12.01XA for initial encounter for closed fracture
  • BILLABLE CODE - Use S12.01XB for initial encounter for open fracture
  • BILLABLE CODE - Use S12.01XD for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S12.01XG for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S12.01XK for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S12.01XS for sequela
  • NON-BILLABLE CODE - S12.02 for Unstable burst fracture of first cervical vertebra
  • BILLABLE CODE - Use S12.02XA for initial encounter for closed fracture
  • BILLABLE CODE - Use S12.02XB for initial encounter for open fracture
  • BILLABLE CODE - Use S12.02XD for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S12.02XG for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S12.02XK for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S12.02XS for sequela
  • NON-BILLABLE CODE - S12.03 for Posterior arch fracture of first cervical vertebra
  • NON-BILLABLE CODE - S12.030 for Displaced posterior arch fracture of first cervical vertebra
  • BILLABLE CODE - Use S12.030A for initial encounter for closed fracture
  • BILLABLE CODE - Use S12.030B for initial encounter for open fracture
  • BILLABLE CODE - Use S12.030D for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S12.030G for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S12.030K for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S12.030S for sequela
  • NON-BILLABLE CODE - S12.031 for Nondisplaced posterior arch fracture of first cervical vertebra
  • BILLABLE CODE - Use S12.031A for initial encounter for closed fracture
  • BILLABLE CODE - Use S12.031B for initial encounter for open fracture
  • BILLABLE CODE - Use S12.031D for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S12.031G for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S12.031K for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S12.031S for sequela
  • NON-BILLABLE CODE - S12.04 for Lateral mass fracture of first cervical vertebra
  • NON-BILLABLE CODE - S12.040 for Displaced lateral mass fracture of first cervical vertebra
  • BILLABLE CODE - Use S12.040A for initial encounter for closed fracture
  • BILLABLE CODE - Use S12.040B for initial encounter for open fracture
  • BILLABLE CODE - Use S12.040D for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S12.040G for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S12.040K for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S12.040S for sequela
  • NON-BILLABLE CODE - S12.041 for Nondisplaced lateral mass fracture of first cervical vertebra
  • BILLABLE CODE - Use S12.041A for initial encounter for closed fracture
  • BILLABLE CODE - Use S12.041B for initial encounter for open fracture
  • BILLABLE CODE - Use S12.041D for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S12.041G for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S12.041K for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S12.041S for sequela
  • NON-BILLABLE CODE - S12.09 for Other fracture of first cervical vertebra
  • NON-BILLABLE CODE - S12.090 for Other displaced fracture of first cervical vertebra
  • BILLABLE CODE - Use S12.090A for initial encounter for closed fracture
  • BILLABLE CODE - Use S12.090B for initial encounter for open fracture
  • BILLABLE CODE - Use S12.090D for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S12.090G for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S12.090K for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S12.090S for sequela
  • NON-BILLABLE CODE - S12.091 for Other nondisplaced fracture of first cervical vertebra
  • BILLABLE CODE - Use S12.091A for initial encounter for closed fracture
  • BILLABLE CODE - Use S12.091B for initial encounter for open fracture
  • BILLABLE CODE - Use S12.091D for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S12.091G for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S12.091K for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S12.091S for sequela

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code S12.0:


Inclusion Terms

Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.

Information for Patients


Fractures

A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the bone.

Symptoms of a fracture are

You need to get medical care right away for any fracture. An x-ray can tell if your bone is broken. You may need to wear a cast or splint. Sometimes you need surgery to put in plates, pins or screws to keep the bone in place.


[Learn More in MedlinePlus]

Neck Injuries and Disorders

Any part of your neck - muscles, bones, joints, tendons, ligaments, or nerves - can cause neck problems. Neck pain is very common. Pain may also come from your shoulder, jaw, head, or upper arms.

Muscle strain or tension often causes neck pain. The problem is usually overuse, such as from sitting at a computer for too long. Sometimes you can strain your neck muscles from sleeping in an awkward position or overdoing it during exercise. Falls or accidents, including car accidents, are another common cause of neck pain. Whiplash, a soft tissue injury to the neck, is also called neck sprain or strain.

Treatment depends on the cause, but may include applying ice, taking pain relievers, getting physical therapy or wearing a cervical collar. You rarely need surgery.


[Learn More in MedlinePlus]

Code History

  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)