M48.4 vs S22.0
M48.4 (Fatigue fracture of vertebra) compared with S22.0 (Fracture of thoracic 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 S22.0: “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 | S22.0Fracture of thoracic vertebra | |
|---|---|---|
| Billing status | Non-billable header Report instead: M48.40XA, M48.40XD, M48.40XG, M48.40XS, M48.41XA | Non-billable header Report instead: S22.000A, S22.000B, S22.000D, S22.000G, S22.000K |
| 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 thoracic vertebra is a non-billable ICD-10-CM category code (S22.0). |
| 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 each code from category S22 |
| Includes | Stress fracture of vertebra | fracture of thoracic neural arch fracture of thoracic spinous process fracture of thoracic transverse process fracture of thoracic vertebra |
| Code first | — | , if applicable, spinal cord injury (S24.0-, S24.1-) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources