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Compare/M48.40XS vs M84.68

M48.40XS vs M84.68

M48.40XS (Fatigue fracture of vertebra, site unspecified, sequela of fracture) compared with M84.68 (Pathological fracture in other disease, other 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. M48.40XS carries an Excludes1 note covering M84.68: “pathological fracture of vertebra due to other diagnosis (M84.68)”

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

M48.40XSFatigue fracture of vertebra, site unspecified, sequela of fractureM84.68Pathological fracture in other disease, other site
Billing statusBillableNon-billable header

Report instead: M84.68XA, M84.68XD, M84.68XG, M84.68XK, M84.68XP

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, site unspecified, sequela of fracture is a billable ICD-10-CM diagnosis code (M48.40S).Pathological fracture in other disease, other site is a non-billable ICD-10-CM category code (M84.68).
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 M84.6:

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