M48.40XG vs M84.4
M48.40XG (Fatigue fracture of vertebra, site unspecified, subsequent encounter for fracture with delayed healing) compared with M84.4 (Pathological fracture, not elsewhere classified), 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. M48.40XG carries an Excludes1 note covering M84.4: “pathological fracture NOS (M84.4-)”
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
| M48.40XGFatigue fracture of vertebra, site unspecified, subsequent encounter for fracture with delayed healing | M84.4Pathological fracture, not elsewhere classified | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: M84.40XA, M84.40XD, M84.40XG, M84.40XK, M84.40XP |
| Classification | M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) | M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) |
| Definition | Fatigue fracture of vertebra, site unspecified, subsequent encounter for fracture with delayed healing is a billable ICD-10-CM diagnosis code (M48.40G). | Pathological fracture, not elsewhere classified is a non-billable ICD-10-CM category code (M84.4). |
| 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 subcategory M84.4: |
| Includes | — | Chronic fracture Pathological fracture NOS |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources