M48.40XG vs S12.0
M48.40XG (Fatigue fracture of vertebra, site unspecified, subsequent encounter for fracture with delayed healing) 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. M48.40XG 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
| M48.40XGFatigue fracture of vertebra, site unspecified, subsequent encounter for fracture with delayed healing | S12.0Fracture of first cervical vertebra | |
|---|---|---|
| Billing status | Billable | 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, site unspecified, subsequent encounter for fracture with delayed healing is a billable ICD-10-CM diagnosis code (M48.40G). | 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 | — | 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