Pain Management Coding Alert

ICD-10:

Pay Attention to Spinal Region When Coding for Neck Sprain

Tip: The smallest details can make a difference.

When you still coded with ICD-9, a single code represented neck sprain and strain: 847.0 (Neck sprain) under category 847 (Sprains and strains of other and unspecified parts of back). Now, with ICD-10, you report neck sprain using S13.- (Dislocation and sprain of joints and ligaments at neck level). This code includes:

  • 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
  • Traumatic rupture of joint or ligament at neck level
  • Traumatic subluxation of joint or ligament at neck level
  • Traumatic tear of joint or ligament at neck level.

ICD-10 includes a fourth character to identify sprain of specific parts of the cervical regions such as:

  • S13.4xx_, Sprain of ligaments of cervical spine
  • S13.5xx_, Sprain of thyroid region
  • S13.8xx_, Sprain of joints and ligaments of other parts of neck.

Take note: Don’t miss the Excludes2 note for the S13 category regarding strain of muscle or tendon at neck level (S16.1).

Add the appropriate seventh character to each of these codes to indicate the encounter type:

  • A – Initial encounter (active treatment)
  • D – Subsequent encounter (routine care during healing / recovery)
  • S – Sequela (complications).

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