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.

Check S13.4XXD with the rest of the claim: free scrubber

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

Not part of this code, but both may be coded when both are present.

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

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

S13.4XXD is named in 5 Medicare coverage policies: 5 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy
A57079Billing and Coding: Injections - Tendon, Ligament, and Ganglion Cyst
A57204Billing and Coding: MRI and CT Scans of the Head and Neck

Code history

Unchanged in every release from FY2024 to FY2027.