Type II occipital condyle fracture, left side, init

This code signifies a fracture of the left occipital condyle, specifically a Type II fracture, which involves the base of the condyle and extends into the foramen magnum. This type of fracture is typically stable but can be associated with craniocervical junction instability. It represents the initial treatment phase for a closed injury.

Use this code for a patient presenting with a newly diagnosed, non-displaced or minimally displaced Type II fracture of the left occipital condyle, where the skin remains intact over the fracture site. Documentation should clearly specify the left side, fracture type (Type II), and indicate that this is the first encounter for treatment of this specific injury.

• Ensure documentation explicitly states "Type II" and "left side" to support code assignment.
• Verify the encounter type; "initial encounter" is for active treatment, not follow-up care.
• Distinguish from Type I (impaction) and Type III (avulsion) occipital condyle fractures, which have different code assignments.