S12.201S
S12.201S — Unspecified nondisplaced fracture of third cervical vertebra, sequela
Billable / specific codeICD-10-CMPOA exempt
S12.201S is a billable, specific ICD-10-CM code for unspecified nondisplaced fracture of third cervical vertebra, sequela. It is valid for submission on a claim.
7th character "S" — sequela
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
S12.201S 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
S12.201S is named in 12 Medicare coverage policies — 12 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53058Billing and Coding: Home Health Physical Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
Related codes at this level
Codes that share S12.201. If S12.201S is not quite right, the correct code is usually one of these.
- S12.201AUnspecified nondisplaced fracture of third cervical vertebra, initial encounter for closed fracture
- S12.201BUnspecified nondisplaced fracture of third cervical vertebra, initial encounter for open fracture
- S12.201DUnspecified nondisplaced fracture of third cervical vertebra, subsequent encounter for fracture with routine healing
- S12.201GUnspecified nondisplaced fracture of third cervical vertebra, subsequent encounter for fracture with delayed healing
- S12.201KUnspecified nondisplaced fracture of third cervical vertebra, subsequent encounter for fracture with nonunion
Questions about S12.201S
- Is S12.201S a billable ICD-10-CM code?
- Yes. S12.201S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S12.201S 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).