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M48.40XD ICD-10-CM Code: Fatigue fracture of vertebra, site unspecified, subsequent encounter for fracture with routine healing

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 559 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)
  • MS-DRG 560 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC (MDC 08)
  • MS-DRG 561 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC (MDC 08)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Official Registry Overview & Definition

Fatigue fracture of vertebra, site unspecified, subsequent encounter for fracture with routine healing is a billable ICD-10-CM diagnosis code (M48.40D).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for M48.40XD in the official ICD-10-CM tabular list.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Frequently Compared Codes

The official Excludes notes on M48.40XD name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Contextual Map

Every relationship of M48.40XD in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • M00-M99 — Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) (M00-M99) [Hierarchy]
  • M45-M49 — Spondylopathies [Hierarchy]

Referenced by Excludes1 notes

  • G55 — Nerve root and plexus compressions in diseases classified elsewhere [Excludes1](via M48.-): “nerve root compression (due to) (in) spondylopathies (M46.-, M48.-)” · check together

Referenced by Excludes2 notes

  • M84.3 — Stress fracture [Excludes2](via M48.4.-): “stress fracture of vertebra (M48.4-)” · check together

Clinical classification (CCSR)

  • MUS017 — Stress fracture, subsequent encounter [CCSR]

Potential MS-DRG

  • DRG 559 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)”
  • DRG 560 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC (MDC 08)”
  • DRG 561 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC (MDC 08)”

MDC crossing · procedures (18508)

  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue [MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 005T0ZZ — Destruction of Spinal Meninges, Open Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T3ZZ — Destruction of Spinal Meninges, Percutaneous Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T4ZZ — Destruction of Spinal Meninges, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Endoscopic Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0Z3 — Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0ZZ — Destruction of Cervical Spinal Cord, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • and 18503 more

Nearest codes (40)

  • M48 — Other spondylopathies [Sibling]
  • M48.21 — Kissing spine, occipito-atlanto-axial region [Sibling]
  • M48.22 — Kissing spine, cervical region [Sibling]
  • M48.23 — Kissing spine, cervicothoracic region [Sibling]
  • M48.24 — Kissing spine, thoracic region [Sibling]
  • M48.25 — Kissing spine, thoracolumbar region [Sibling]
  • M48.26 — Kissing spine, lumbar region [Sibling]
  • M48.27 — Kissing spine, lumbosacral region [Sibling]
  • and 32 more

Referenced by Other Codes

Clinical classification (AHRQ CCSR):MUS017 — Stress fracture, subsequent encounter (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 3 MS-DRGs: DRG 559 (MDC 08), DRG 560 (MDC 08), DRG 561 (MDC 08).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Official ICD-10-CM tabular notes on other codes that name M48.40XD or its code family.

1 Excludes1 notes: G55 (via M48.-).

1 Excludes2 notes: M84.3 (via M48.4.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does M48.40XD require a 7th character?

Yes. The appropriate 7th character is to be added to each code from subcategory M48.4:.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to M48.40XD in its code family, with their registry titles.

  • M48.37 — Traumatic spondylopathy, lumbosacral region
  • M48.38 — Traumatic spondylopathy, sacral and sacrococcygeal region
  • M48.4 — Fatigue fracture of vertebra
  • M48.40 — Fatigue fracture of vertebra, site unspecified
  • M48.40XA — Fatigue fracture of vertebra, site unspecified, initial encounter for fracture
  • M48.40XG — Fatigue fracture of vertebra, site unspecified, subsequent encounter for fracture with delayed healing
  • M48.40XS — Fatigue fracture of vertebra, site unspecified, sequela of fracture
  • M48.41 — Fatigue fracture of vertebra, occipito-atlanto-axial region
  • M48.41XA — Fatigue fracture of vertebra, occipito-atlanto-axial region, initial encounter for fracture
  • M48.41XD — Fatigue fracture of vertebra, occipito-atlanto-axial region, subsequent encounter for fracture with routine healing

View all codes in the M48 family