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Compare/M48.51XG vs M84.4

M48.51XG vs M84.4

M48.51XG (Collapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, subsequent encounter for fracture with delayed healing) 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. M48.51XG 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 M48.51XG: “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

M48.51XGCollapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, subsequent encounter for fracture with delayed healingM84.4Pathological fracture, not elsewhere classified
Billing statusBillableNon-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, occipito-atlanto-axial region, subsequent encounter for fracture with delayed healing is a billable ICD-10-CM diagnosis code (M48.51G).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
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