S12.3 — Fracture of fourth cervical vertebra
S12.3 is a non-billable header ICD-10-CM code for fracture of fourth cervical vertebra. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
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 S12.3
These codes carry an Excludes1 note pointing at S12.3. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S12.3 alone.
- M48.4Fatigue fracture of vertebra
Risk adjustment
S12.3 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.
Code to one of these instead S12.3
5 child codes. Green means billable.
- S12.30Unspecified fracture of fourth cervical vertebra
- S12.33Unspecified traumatic spondylolisthesis of fourth cervical vertebra
- S12.34Type III traumatic spondylolisthesis of fourth cervical vertebra
- S12.35Other traumatic spondylolisthesis of fourth cervical vertebra
- S12.39Other fracture of fourth cervical vertebra
Related codes at this level
Codes that share S12. If S12.3 is not quite right, the correct code is usually one of these.
- S12.0Fracture of first cervical vertebra
- S12.1Fracture of second cervical vertebra
- S12.2Fracture of third cervical vertebra
- S12.4Fracture of fifth cervical vertebra
- S12.5Fracture of sixth cervical vertebra
- S12.6Fracture of seventh cervical vertebra
- S12.8Fracture of other parts of neck
- S12.9Fracture of neck, unspecified
Questions about S12.3
- Is S12.3 a billable ICD-10-CM code?
- No. S12.3 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S12.3 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).