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Compare/M48.57XA vs M84.58

M48.57XA vs M84.58

M48.57XA (Collapsed vertebra, not elsewhere classified, lumbosacral region, initial encounter for fracture) compared with M84.58 (Pathological fracture in neoplastic disease, other specified site), 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. M48.57XA carries an Excludes1 note covering M84.58: “pathological fracture of vertebra due to neoplasm (M84.58)”

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

M48.57XACollapsed vertebra, not elsewhere classified, lumbosacral region, initial encounter for fractureM84.58Pathological fracture in neoplastic disease, other specified site
Billing statusBillableNon-billable header

Report instead: M84.58XA, M84.58XD, M84.58XG, M84.58XK, M84.58XP

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, lumbosacral region, initial encounter for fracture is a billable ICD-10-CM diagnosis code (M48.57A).Pathological fracture in neoplastic disease, other specified site is a non-billable ICD-10-CM category code (M84.58).
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 M84.5:
Includes
Pathological fracture in neoplastic disease, vertebrae

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