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M48.4 vs M84.376G

M48.4 (Fatigue fracture of vertebra) compared with M84.376G (Stress fracture, unspecified foot, subsequent encounter for fracture with delayed healing), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because M84.376G lists M48.4 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named and billing status.M48.4 is “Fatigue fracture of vertebra”; M84.376G is “Stress fracture, unspecified foot, subsequent encounter for fracture with delayed healing”. M48.4 is a non-billable header; M84.376G is billable.

Registry fact

Can these codes be reported together?

Yes, when both are documented.M84.376G lists M48.4 under Excludes2: “stress fracture of vertebra (M48.4-)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. M48.4 carries 5 Excludes1 notes and M84.376G carries 3 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.M84.376G’s tabular entry: “stress fracture of vertebra (M48.4-)”. The note covers M48.4.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

One is a header.M48.4 is a non-billable header, but M84.376G is not one of its subdivisions.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

M84.376G
Stress fracture, unspecified foot, subsequent encounter for fracture with delayed healing
↔
M48.4
Fatigue fracture of vertebra

What we found

Yes, when both are documented.M84.376G carries an Excludes2 note covering M48.4: “stress fracture of vertebra (M48.4-)”

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

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

M48.4Fatigue fracture of vertebraM84.376GStress fracture, unspecified foot, subsequent encounter for fracture with delayed 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).Stress fracture, unspecified foot, subsequent encounter for fracture with delayed healing is a billable ICD-10-CM diagnosis code (M84.376G).
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 M84.3:
Includes
Stress fracture of vertebra
—
Excludes1
pathological fracture NOS (M84.4-)
pathological fracture of vertebra due to neoplasm (M84.58)
pathological fracture of vertebra due to other diagnosis (M84.68)
pathological fracture of vertebra due to osteoporosis (M80.-)
traumatic fracture of vertebrae (S12.0-S12.3-, S22.0-, S32.0-)
pathological fracture NOS (M84.4.-)
pathological fracture due to osteoporosis (M80.-)
traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)
Excludes2—
personal history of (healed) stress (fatigue) fracture (Z87.312)
stress fracture of vertebra (M48.4-)
traumatic fracture of bone-see fracture, by site
Use additional code—
external cause code(s) to identify the cause of the stress fracture

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.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources