M48.5 vs M80.88XP
M48.5 (Collapsed vertebra, not elsewhere classified) compared with M80.88XP (Other osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with malunion), 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. M48.5 carries an Excludes1 note covering M80.88XP: “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).
No — do not report together. M80.88XP carries an Excludes1 note covering M48.5: “collapsed vertebra NOS (M48.5)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
No — do not report together. M80.88XP carries an Excludes1 note covering M48.5: “wedging of vertebra NOS (M48.5)”
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
| M48.5Collapsed vertebra, not elsewhere classified | M80.88XPOther osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with malunion | |
|---|---|---|
| Billing status | Non-billable header Report instead: M48.50XA, M48.50XD, M48.50XG, M48.50XS, M48.51XA | Billable |
| 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 | Collapsed vertebra, not elsewhere classified is a non-billable ICD-10-CM category code (M48.5). | Other osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with malunion is a billable ICD-10-CM diagnosis code (M80.88P). |
| 7th character | The appropriate 7th character is to be added to each code from subcategory M48.5: | The appropriate 7th character is to be added to each code from category M80: |
| Includes | Collapsed vertebra NOS Compression fracture of vertebra NOS Wedging of vertebra NOS | osteoporosis with current fragility fracture |
| Use additional code | — | code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5) 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