Is S13.4XXD a billable ICD-10-CM code?

Yes. S13.4XXD is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S13.4XXD 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).

S13.4XXD

S13.4XXD — Sprain of ligaments of cervical spine, subsequent encounter

Billable / specific codeICD-10-CMPOA exempt

S13.4XXD is a billable, specific ICD-10-CM code for sprain of ligaments of cervical spine, subsequent encounter. It is valid for submission on a claim.

7th character "D" — subsequent encounter

The appropriate 7th character is to be added to each code from category S13

A: initial encounter
D: subsequent encounter
S: sequela

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Sprain of anterior longitudinal (ligament), cervical
Sprain of atlanto-axial (joints)
Sprain of atlanto-occipital (joints)
Whiplash injury of cervical spine

Excludes2 inherited from the categories above S13.4XXD

Also inherited, and the opposite of Excludes1: these conditions are not part of S13.4XXD, but a patient can have both, so you may code both.

Written on S13 — Dislocation and sprain of joints and ligaments at neck level

strain of muscle or tendon at neck level (S16.1)

Risk adjustment

S13.4XXD 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

S13.4XXD is named in 5 Medicare coverage policies — 5 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
A57079Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
A57204Billing and Coding: MRI and CT Scans of the Head and Neck

Code history

S13.4XXD has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share S13.4. If S13.4XXD is not quite right, the correct code is usually one of these.

Questions about S13.4XXD

Is S13.4XXD a billable ICD-10-CM code?: Yes. S13.4XXD is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S13.4XXD 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).