S12.100K — Unspecified displaced fracture of second cervical vertebra, subsequent encounter for fracture with nonunion
S12.100K is a billable, specific ICD-10-CM code for unspecified displaced fracture of second cervical vertebra, subsequent encounter for fracture with nonunion. It is valid for submission on a claim.
7th character "K" — subsequent encounter for fracture with nonunion
The appropriate 7th character is to be added to all codes from subcategories S12.0-S12.6
- A
- initial encounter for closed fracture
- B
- initial encounter for open fracture
- D
- subsequent encounter for fracture with routine healing
- G
- subsequent encounter for fracture with delayed healing
- K
- subsequent encounter for fracture with nonunion
- S
- sequela
Risk adjustment
S12.100K does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
S12.100K is named in 11 Medicare coverage policies — 11 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
- A57311Billing and Coding: Physical Therapy - Home Health
Related codes at this level
Codes that share S12.100. If S12.100K is not quite right, the correct code is usually one of these.
- S12.100AUnspecified displaced fracture of second cervical vertebra, initial encounter for closed fracture
- S12.100BUnspecified displaced fracture of second cervical vertebra, initial encounter for open fracture
- S12.100DUnspecified displaced fracture of second cervical vertebra, subsequent encounter for fracture with routine healing
- S12.100GUnspecified displaced fracture of second cervical vertebra, subsequent encounter for fracture with delayed healing
- S12.100SUnspecified displaced fracture of second cervical vertebra, sequela
Questions about S12.100K
- Is S12.100K a billable ICD-10-CM code?
- Yes. S12.100K is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S12.100K sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the neck (S10-S19).