S12.231K — Unspecified traumatic nondisplaced spondylolisthesis of third cervical vertebra, subsequent encounter for fracture with nonunion
S12.231K is a billable, specific ICD-10-CM code for unspecified traumatic nondisplaced spondylolisthesis of third 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
S12.231K 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
S12.231K is named in 10 Medicare coverage policies — 10 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
- A57311Billing and Coding: Physical Therapy - Home Health
- A59608Billing and Coding: Cervical Fusion
Related codes at this level
Codes that share S12.231. If S12.231K is not quite right, the correct code is usually one of these.
- S12.231AUnspecified traumatic nondisplaced spondylolisthesis of third cervical vertebra, initial encounter for closed fracture
- S12.231BUnspecified traumatic nondisplaced spondylolisthesis of third cervical vertebra, initial encounter for open fracture
- S12.231DUnspecified traumatic nondisplaced spondylolisthesis of third cervical vertebra, subsequent encounter for fracture with routine healing
- S12.231GUnspecified traumatic nondisplaced spondylolisthesis of third cervical vertebra, subsequent encounter for fracture with delayed healing
- S12.231SUnspecified traumatic nondisplaced spondylolisthesis of third cervical vertebra, sequela
Questions about S12.231K
- Is S12.231K a billable ICD-10-CM code?
- Yes. S12.231K is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S12.231K 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).