M48.48XS vs S12.0

M48.48XS (Fatigue fracture of vertebra, sacral and sacrococcygeal region, sequela of fracture) 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.

Relationship

Conflict

Excludes1 conflict

M48.48XS

Fatigue fracture of vertebra, sacral and sacrococcygeal region, sequela of fracture

↔

S12.0

Fracture of first cervical vertebra

Not coded here — these two are mutually exclusive.

“traumatic fracture of vertebrae (S12.0-S12.3-, S22.0-, S32.0-)”

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.

Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Can these codes be reported together?

No — do not report together. M48.48XS 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

	M48.48XSFatigue fracture of vertebra, sacral and sacrococcygeal region, sequela of fracture	S12.0Fracture of first cervical vertebra
Billing status	Billable	Non-billable header
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, sacral and sacrococcygeal region, sequela of fracture is a billable ICD-10-CM diagnosis code (M48.48S).	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-)

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