M48.42XS vs M80
M48.42XS (Fatigue fracture of vertebra, cervical region, sequela of fracture) compared with M80 (Osteoporosis with current pathological fracture), 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. M48.42XS carries an Excludes1 note covering M80: “pathological fracture of vertebra due to osteoporosis (M80.-)”
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
| M48.42XSFatigue fracture of vertebra, cervical region, sequela of fracture | M80Osteoporosis with current pathological fracture | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: M80.00XA, M80.00XD, M80.00XG, M80.00XK, M80.00XP |
| 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, cervical region, sequela of fracture is a billable ICD-10-CM diagnosis code (M48.42S). | Osteoporosis with current pathological fracture is a non-billable ICD-10-CM category code (M80). |
| 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 M80: |
| Includes | — | osteoporosis with current fragility fracture |
| Use additional code | — | code to identify major osseous defect, if applicable (M89.7-) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources