M48.56XG vs M80
M48.56XG (Collapsed vertebra, not elsewhere classified, lumbar region, subsequent encounter for fracture with delayed healing) compared with M80 (Osteoporosis with current pathological fracture), 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. M48.56XG carries an Excludes1 note covering M80: “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 carries an Excludes1 note covering M48.56XG: “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 carries an Excludes1 note covering M48.56XG: “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
| M48.56XGCollapsed vertebra, not elsewhere classified, lumbar region, subsequent encounter for fracture with delayed healing | M80Osteoporosis with current pathological fracture | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: M80.00XA, M80.00XD, M80.00XG, M80.00XK, M80.00XP |
| 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, lumbar region, subsequent encounter for fracture with delayed healing is a billable ICD-10-CM diagnosis code (M48.56G). | Osteoporosis with current pathological fracture is a non-billable ICD-10-CM category code (M80). |
| 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 | — | osteoporosis with current fragility fracture |
| Use additional code | — | 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