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Compare/M48.4 vs M84.58

M48.4 vs M84.58

M48.4 (Fatigue fracture of vertebra) compared with M84.58 (Pathological fracture in neoplastic disease, other specified site), 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. M48.4 carries an Excludes1 note covering M84.58: “pathological fracture of vertebra due to neoplasm (M84.58)”

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 vertebraM84.58Pathological fracture in neoplastic disease, other specified site
Billing statusNon-billable header

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

Non-billable header

Report instead: M84.58XA, M84.58XD, M84.58XG, M84.58XK, M84.58XP

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).Pathological fracture in neoplastic disease, other specified site is a non-billable ICD-10-CM category code (M84.58).
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 M84.5:
Includes
Stress fracture of vertebra
Pathological fracture in neoplastic disease, vertebrae

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