S12.111A: Posterior displaced Type II dens fracture, initial encounter for closed fracture
S12.111A is a billable, specific ICD-10-CM code for posterior displaced type ii dens fracture, initial encounter for closed fracture. It is valid for submission on a claim.
Check S12.111A with the rest of the claim: free scrubber7th character "A": initial encounter for closed fracture
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
Other codes that can never be billed with S12.111A
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
S12.111A risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 401 Vertebral Fractures without Spinal Cord Injury0.522 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
S12.111A is named in 13 Medicare coverage policies: 13 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A57132Billing and Coding: Bone Mass Measurement
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
- A57205Billing and Coding: Oximetry Services
- A57311Billing and Coding: Physical Therapy - Home Health
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S12.111
- S12.111BPosterior displaced Type II dens fracture, initial encounter for open fracture
- S12.111DPosterior displaced Type II dens fracture, subsequent encounter for fracture with routine healing
- S12.111GPosterior displaced Type II dens fracture, subsequent encounter for fracture with delayed healing
- S12.111KPosterior displaced Type II dens fracture, subsequent encounter for fracture with nonunion
- S12.111SPosterior displaced Type II dens fracture, sequela