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S12.000K ICD-10-CM Code: Unspecified displaced fracture of first cervical vertebra, subsequent encounter for fracture with nonunion

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FY 2026 Apr update / Injury, poisoning and certain other consequences of external causes (S00-T88) / Injuries to the neck (S10-S19)

S12.000K

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Unspecified displaced fracture of first cervical vertebra, subsequent encounter for fracture with nonunion

Unspecified displaced fracture of first cervical vertebra, subsequent encounter for fracture with nonunion

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
S12.00Unspecified fracture of first cervical vertebra
S12.000Unspecified displaced fracture of first cervical vertebra
S12.000KUnspecified displaced fracture of first cervical vertebra, subsequent encounter for fracture with nonunion

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for S12.000K in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for S12.000K in this effective period.

Related Child Codes

Official
S12.000AUnspecified displaced fracture of first cervical vertebra, initial encounter for closed fracture
S12.000BUnspecified displaced fracture of first cervical vertebra, initial encounter for open fracture
S12.000DUnspecified displaced fracture of first cervical vertebra, subsequent encounter for fracture with routine healing
S12.000GUnspecified displaced fracture of first cervical vertebra, subsequent encounter for fracture with delayed healing
S12.000SUnspecified displaced fracture of first cervical vertebra, sequela

Includes

Official

ICD-10-CM does not list Includes notes for S12.000K in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for S12.000K in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for S12.000K in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for S12.000K in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for S12.000K in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is S12.000K an HCC code?

No. S12.000K is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

S12.000K is the ICD-10-CM diagnosis code for unspecified displaced fracture of first cervical vertebra, subsequent encounter for fracture with nonunion. S12.000K sits in the ICD-10-CM chapter for injury, poisoning and certain other consequences of external causes (s00-t88), within the section covering injuries to the neck (s10-s19).

S12.000K is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

S12.000K is a billable ICD-10-CM code that can be reported on claims but does not currently contribute to a Medicare Advantage member's RAF score under any CMS risk adjustment model (V28, V24, ESRD, or RxHCC). Coders reviewing S12.000K should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for S12.000K sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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