Skip to main content

M48.5 vs M84.40XS

M48.5 (Collapsed vertebra, not elsewhere classified) compared with M84.40XS (Pathological fracture, unspecified site, sequela), 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 M84.40XS: “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. M84.40XS 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 classifiedM84.40XSPathological fracture, unspecified site, sequela
Billing statusNon-billable header

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

Billable
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, unspecified site, sequela is a billable ICD-10-CM diagnosis code (M84.40S).
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

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