2027 ICD-10-CM Diagnosis Code S14.134AAnterior cord syndrome at C4 level of cervical spinal cord, initial encounter
ICD-10-CM Codes›S00–T88›S10-S19›S14
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 182
- 7th Character A — Initial Encounter
- Chronic Condition
S14.134A is a billable ICD-10-CM diagnosis code for anterior cord syndrome at C4 level of cervical spinal cord, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 52 through 53, 963 through 965. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 569 closely related codes. Coders also document this condition as anterior cervical spinal cord injury at C1-C4 level without spinal bone injury. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Spinal cord injury (SCI), initial encounter.
For Medicare Advantage risk adjustment, S14.134A maps to CMS-HCC Category 182 (Spinal Cord Disorders/Injuries) under the V28 model, adding a risk factor of about 0.478 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
S14.134A maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Anterior cervical spinal cord injury at C1-C4 level without spinal bone injury
- Anterior cord syndrome of cervical spinal cord at C4 level
- Incomplete spinal cord lesion at C1-C4 level without bone injury
- Injury at C1-C4 level with spinal cord injury AND without bone injury
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Injury of nerves and spinal cord at neck level (S14). Use the following options for the applicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, published by CMS and the National Center for Health Statistics.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to S14.134A: its own notes plus those printed at S14, block S10-S19, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- injuries of nape
- injuries of supraclavicular region
- injuries of throat
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify any retained foreign body, if applicable (Z18.-)
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
Notes
General instructions on how these codes are used.
- Code to highest level of cervical cord injury
- Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
- The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.
7th Character
Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.
- The appropriate 7th character is to be added to each code from category S14
- Ainitial encounter this code
- Dsubsequent encounter
- Ssequela
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name S14.134A, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming S14.134A: they are not reported together with it, unless the two conditions are unrelated.
Code First 2
These codes say to code first a condition named in the note, and S14.134A is one of the conditions named.
Use Additional Code 1
These codes say to use an additional code from the note, and S14.134A is one of the codes named.
Code Also 2
These codes say S14.134A may also be needed to fully describe the condition. The note gives no sequencing direction.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
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.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S14.134A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S14.134AOverview
Is S14.134A (Anterior cord syndrome at C4 level of cervical spinal cord) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report anterior cord syndrome at C4 level of cervical spinal cord, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character A in S14.134A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for anterior cord syndrome at C4 level of cervical spinal cord, such as an emergency visit or first evaluation.
What MS-DRG does S14.134A group to?
When anterior cord syndrome at C4 level of cervical spinal cord, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 964, 965, 53, 963, 52, with relative weights from 0.9723 to 2.6361 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S14.134A a CC or MCC?
CMS lists S14.134A as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 569 closely related codes in its exclusion list.
What is the ICD-9 equivalent of S14.134A?
Under the General Equivalence Mappings, anterior cord syndrome at C4 level of cervical spinal cord, initial encounter converts to ICD-9-CM 952.02 (anterior cord synd/c1-c4). The mapping is approximate, so confirm the match fits the documentation.
What HCC is S14.134A?
S14.134A (anterior cord syndrome at C4 level of cervical spinal cord, initial encounter) maps to CMS-HCC Category 182 (Spinal Cord Disorders/Injuries), commonly written as HCC 182, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 72 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.
Does S14.134A risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, S14.134A adds a risk adjustment factor of about 0.478 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.270 to 0.478 depending on the payment segment). A more severe related category (HCC 180, HCC 181, HCC 191, and HCC 192) supersedes it when both are reported. See the full factor table on the HCC 182 category page.
