S12.9XXA — Fracture of neck, unspecified, initial encounter
S12.9XXA is a billable, specific ICD-10-CM code for fracture of neck, unspecified, initial encounter. It is valid for submission on a claim.
7th character "A" — initial encounter
The appropriate 7th character is to be added to code S12.9
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Fracture of neck NOS
- Fracture of cervical spine NOS
- Fracture of cervical vertebra NOS
Risk adjustment
S12.9XXA 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.
Medicare coverage
S12.9XXA is named in 15 Medicare coverage policies — 15 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56722Billing and Coding: Intraoperative Neurophysiological Testing
- A57132Billing and Coding: Bone Mass Measurement
- A57132Billing and Coding: Bone Mass Measurement
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
Related codes at this level
Codes that share S12.9. If S12.9XXA is not quite right, the correct code is usually one of these.
Questions about S12.9XXA
- Is S12.9XXA a billable ICD-10-CM code?
- Yes. S12.9XXA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S12.9XXA 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).