M48.58XA vs M84.4
M48.58XA (Collapsed vertebra, not elsewhere classified, sacral and sacrococcygeal region, initial encounter for fracture) 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. M48.58XA 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 M48.58XA: “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
| M48.58XACollapsed vertebra, not elsewhere classified, sacral and sacrococcygeal region, initial encounter for fracture | M84.4Pathological fracture, not elsewhere classified | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: M84.40XA, M84.40XD, M84.40XG, M84.40XK, M84.40XP |
| 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, sacral and sacrococcygeal region, initial encounter for fracture is a billable ICD-10-CM diagnosis code (M48.58A). | Pathological fracture, not elsewhere classified is a non-billable ICD-10-CM category code (M84.4). |
| 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 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