Radiology Coding Alert

Question: How should I code a Fracture of the Dens? There was no spinal cord injury or mention of an open fracture.

Missouri Subscriber

Answer: Report 805.02 (Closed fracture of second cervical vertebra) for a dens fracture.

The dens is a projection of the second cervical vertebra. It constricts slightly where it meets the main vertebral body. There are three types of dens-related fractures:

• Type I Fracture: This is a rare fracture involving the tip of dens.
• Type II Fracture: Type II is the most common type and occurs at the base of dens.
• Type III Fracture: This type extends into the vertebral body.

ICD-9 code range 805.xx represents fractures of the vertebral column without mention of spinal injury. A fourth digit of "0" is used for closed fractures. The final digit "2" is specific to the second cervical vertebra.

ICD-10: There are more than a dozen ICD-10 code options that cross to 805.02. Some specifically mention dens fractures, such as S12.110A (Anterior displaced Type II dens fracture, initial encounter for closed fracture).