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Compare/M48.5 vs M84.4

M48.5 vs M84.4

M48.5 (Collapsed vertebra, not elsewhere classified) compared with M84.4 (Pathological fracture, not elsewhere classified), 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 M84.4: “pathological fracture NOS (M84.4-)”

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. M84.4 carries an Excludes1 note covering M48.5: “collapsed vertebra NEC (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 classifiedM84.4Pathological fracture, not elsewhere classified
Billing statusNon-billable header

Report instead: M48.50XA, M48.50XD, M48.50XG, M48.50XS, M48.51XA

Non-billable header

Report instead: M84.40XA, M84.40XD, M84.40XG, M84.40XK, M84.40XP

ClassificationM00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
DefinitionCollapsed vertebra, not elsewhere classified is a non-billable ICD-10-CM category code (M48.5).Pathological fracture, not elsewhere classified is a non-billable ICD-10-CM category code (M84.4).
7th characterThe 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 subcategory M84.4:
Includes
Collapsed vertebra NOS
Compression fracture of vertebra NOS
Wedging of vertebra NOS
Chronic fracture
Pathological fracture NOS

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