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M46.2 vs M86.8X41

M46.2 (Osteomyelitis of vertebra) compared with M86.8X41 (Other osteomyelitis, right hand), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2). MedCoder-derived

Can these codes be reported together?

Informational

Excludes2 relationship

M86.8X41
Other osteomyelitis, right hand
M46.2
Osteomyelitis of vertebra

What we found

Yes, when both are documented.M86.8X41 carries an Excludes2 note covering M46.2: “vertebra (M46.2-)”

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

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Side by side

M46.2Osteomyelitis of vertebraM86.8X41Other osteomyelitis, right hand
Billing statusNon-billable header

Report instead: M46.20, M46.21, M46.22, M46.23, M46.24

Billable
ClassificationM00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
DefinitionOsteomyelitis of vertebra is a non-billable ICD-10-CM category code (M46.2).Other osteomyelitis, right hand is a billable ICD-10-CM diagnosis code (M86.8X41).
Excludes1
osteomyelitis due to:
echinococcus (B67.2)
gonococcus (A54.43)
salmonella (A02.24)
postprocedural osteopathies (M96.-)
Excludes2
ostemyelitis of:
orbit (H05.0-)
petrous bone (H70.2-)
vertebra (M46.2-)
Use additional code
code (B95-B97) to identify infectious agent
code to identify major osseous defect, if applicable (M89.7-)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

Derived from the official CMS ICD-10-CM tabular data (FY2026). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources