M48.4 vs S12.0
M48.4 (Fatigue fracture of vertebra) compared with S12.0 (Fracture of first cervical vertebra), 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 S12.0: “traumatic fracture of vertebrae (S12.0-S12.3-, S22.0-, S32.0-)”
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 vertebra | S12.0Fracture of first cervical vertebra | |
|---|---|---|
| Billing status | Non-billable header Report instead: M48.40XA, M48.40XD, M48.40XG, M48.40XS, M48.41XA | Non-billable header Report instead: S12.000A, S12.000B, S12.000D, S12.000G, S12.000K |
| Classification | M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Fatigue fracture of vertebra is a non-billable ICD-10-CM category code (M48.4). | Fracture of first cervical vertebra is a non-billable ICD-10-CM category code (S12.0). |
| 7th character | The appropriate 7th character is to be added to each code from subcategory M48.4: | The appropriate 7th character is to be added to all codes from subcategories S12.0-S12.6 |
| Includes | Stress fracture of vertebra | fracture of cervical neural arch fracture of cervical spine fracture of cervical spinous process fracture of cervical transverse process |
| Code first | — | any associated cervical spinal cord injury (S14.0, S14.1-) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources