M48.41XD (Fatigue fracture of vertebra, occipito-atlanto-axial region, subsequent encounter for fracture with routine healing)
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.
Pathological fracture in other disease, other site
Not coded here — these two are mutually exclusive.
“pathological fracture of vertebra due to other diagnosis (M84.68)”
An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.
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, occipito-atlanto-axial region, subsequent encounter for fracture with routine healing is a billable ICD-10-CM diagnosis code (M48.41D).
Pathological fracture in other disease, other site is a non-billable ICD-10-CM category code (M84.68).
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 M84.6: