2025 ICD-10-CM code S12.691A
Initial encounter for a closed, nondisplaced fracture of the seventh cervical vertebra.
Medical necessity for this code is established by the presence of a documented fracture of the seventh cervical vertebra. The documentation should support the need for diagnostic testing and treatment.
In simple words: This code represents a break in the lowest bone of your neck (C7), which hasn't shifted out of place and didn't break the skin. It's used during your first visit for this injury.
Other nondisplaced fracture of seventh cervical vertebra, initial encounter for closed fracture. This code describes a fracture of the C7 vertebra that is not displaced and the skin is intact. It is used for the initial encounter.
Example 1: A patient falls from a ladder and presents to the emergency room with neck pain. X-rays reveal a nondisplaced fracture of the seventh cervical vertebra, and there is no open wound., A patient is involved in a motor vehicle accident and experiences neck pain. A CT scan shows a closed, nondisplaced fracture of the C7 vertebra. This is the patient's first visit for this injury., During a football game, a player sustains a neck injury. Imaging reveals a nondisplaced fracture of the seventh cervical vertebra without any skin lacerations. The patient seeks medical attention for the first time for this injury.
Physician documentation should include details of the injury mechanism, physical exam findings (e.g., pain, limited range of motion, neurological deficits), and imaging results confirming the nondisplaced fracture of the seventh cervical vertebra. Documentation should also clearly indicate that this is the initial encounter for the injury.
** For subsequent encounters or encounters for open fractures or non-union fractures, use the appropriate 7th character code. Refer to iFrameAI if your specific coding scenario is not fully covered here for precise guidance.
- Specialties:Emergency Medicine, Orthopedic Surgery, Neurosurgery, Radiology
- Place of Service: "Office", "Inpatient Hospital", "On Campus-Outpatient Hospital", "Emergency Room - Hospital", "Urgent Care Facility", "Ambulatory Surgical Center", "Independent Clinic", "Outreach Site/Street"