M48.42XS vs S12.3
M48.42XS (Fatigue fracture of vertebra, cervical region, sequela of fracture) compared with S12.3 (Fracture of fourth 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. M48.42XS carries an Excludes1 note covering S12.3: “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
| M48.42XSFatigue fracture of vertebra, cervical region, sequela of fracture | S12.3Fracture of fourth cervical vertebra | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: S12.300A, S12.300B, S12.300D, S12.300G, S12.300K |
| 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, cervical region, sequela of fracture is a billable ICD-10-CM diagnosis code (M48.42S). | Fracture of fourth cervical vertebra is a non-billable ICD-10-CM category code (S12.3). |
| 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