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M48.4 vs M48.51XD

M48.4 (Fatigue fracture of vertebra) compared with M48.51XD (Collapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, subsequent encounter for fracture with routine healing), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. M48.51XD carries an Excludes1 note covering M48.4: “fatigue fracture of vertebra (M48.4)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

No — do not report together. M48.51XD carries an Excludes1 note covering M48.4: “stress fracture of vertebra (M48.4-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

M48.4Fatigue fracture of vertebraM48.51XDCollapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, subsequent encounter for fracture with routine healing
Billing statusNon-billable header

Report instead: M48.40XA, M48.40XD, M48.40XG, M48.40XS, M48.41XA

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)
DefinitionFatigue fracture of vertebra is a non-billable ICD-10-CM category code (M48.4).Collapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, subsequent encounter for fracture with routine healing is a billable ICD-10-CM diagnosis code (M48.51D).
7th characterThe appropriate 7th character is to be added to each code from subcategory M48.4:The appropriate 7th character is to be added to each code from subcategory M48.5:
Includes
Stress fracture of vertebra

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources