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Compare/S12.3 vs S13.1

S12.3 vs S13.1

S12.3 (Fracture of fourth cervical vertebra) compared with S13.1 (Subluxation and dislocation of cervical vertebrae), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Can these codes be reported together?

Yes, when both are documented. S13.1 carries an Excludes2 note covering S12.3: “fracture of cervical vertebrae (S12.0-S12.3-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

S12.3Fracture of fourth cervical vertebraS13.1Subluxation and dislocation of cervical vertebrae
Billing statusNon-billable header

Report instead: S12.300A, S12.300B, S12.300D, S12.300G, S12.300K

Non-billable header

Report instead: S13.100A, S13.100D, S13.100S, S13.101A, S13.101D

ClassificationS00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
DefinitionFracture of fourth cervical vertebra is a non-billable ICD-10-CM category code (S12.3).Subluxation and dislocation of cervical vertebrae is a non-billable ICD-10-CM category code (S13.1).
7th characterThe appropriate 7th character is to be added to all codes from subcategories S12.0-S12.6The appropriate 7th character is to be added to each code from category S13
Includes
fracture of cervical neural arch
fracture of cervical spine
fracture of cervical spinous process
fracture of cervical transverse process
avulsion of joint or ligament at neck level
laceration of cartilage, joint or ligament at neck level
sprain of cartilage, joint or ligament at neck level
traumatic hemarthrosis of joint or ligament at neck level
Code first
any associated cervical spinal cord injury (S14.0, S14.1-)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources