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M46.2 vs M86.8X42

M46.2 (Osteomyelitis of vertebra) compared with M86.8X42 (Other osteomyelitis, left 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

M86.8X42
Other osteomyelitis, left hand
↔
M46.2
Osteomyelitis of vertebra

What we found

Yes, when both are documented.M86.8X42 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 vertebraM86.8X42Other osteomyelitis, left 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, left hand is a billable ICD-10-CM diagnosis code (M86.8X42).
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.

Edit this comparisonCheck a whole claim

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