M48.40XS ICD-10-CM Code: Fatigue fracture of vertebra, site unspecified, sequela of fracture
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 551 — MEDICAL BACK PROBLEMS WITH MCC (MDC 08)
- MS-DRG 552 — MEDICAL BACK PROBLEMS WITHOUT 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
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for M48.40XS 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).
- pathological fracture NOS (M84.4-) Compare M48.40XS vs M84.4 →
- pathological fracture of vertebra due to neoplasm (M84.58) Compare M48.40XS vs M84.58 →
- pathological fracture of vertebra due to other diagnosis (M84.68) Compare M48.40XS vs M84.68 →
- pathological fracture of vertebra due to osteoporosis (M80.-) Compare M48.40XS vs M80 →
- traumatic fracture of vertebrae (S12.0-S12.3-, S22.0-, S32.0-) Compare M48.40XS vs S12.0 →
Change history
No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.
Verify Before Coding
- Billable — reportable as written.
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 M48.40XS 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
- M48.40 — Fatigue fracture of vertebra, site unspecified [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.-)”
Referenced by Excludes2 notes
- M84.3 — Stress fracture [Excludes2](via M48.4.-): “stress fracture of vertebra (M48.4-)”
Clinical classification (CCSR)
- MUS020 — Pathological, stress and atypical fractures, sequela [CCSR]
Potential MS-DRG
- DRG 551 — MEDICAL BACK PROBLEMS WITH MCC [MS-DRG]: “MEDICAL BACK PROBLEMS WITH MCC (MDC 08)”
- DRG 552 — MEDICAL BACK PROBLEMS WITHOUT MCC [MS-DRG]: “MEDICAL BACK PROBLEMS WITHOUT MCC (MDC 08)”
Nearest codes (40)
- M48 — Other spondylopathies [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]
- M48.3 — Traumatic spondylopathy [Sibling]
- M48.30 — Traumatic spondylopathy, site unspecified [Sibling]
- and 32 more
Referenced by Other Codes
Clinical classification (AHRQ CCSR):MUS020 — Pathological, stress and atypical fractures, sequela (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 2 MS-DRGs: DRG 551 (MDC 08), DRG 552 (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 M48.40XS 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 M48.40XS 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 M48.40XS in its code family, with their registry titles.
- 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
- M48.40XD — Fatigue fracture of vertebra, site unspecified, subsequent encounter for fracture with routine healing
- M48.40XG — Fatigue fracture of vertebra, site unspecified, subsequent encounter for fracture with delayed healing
- 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
- M48.41XG — Fatigue fracture of vertebra, occipito-atlanto-axial region, subsequent encounter for fracture with delayed healing
- M48.41XS — Fatigue fracture of vertebra, occipito-atlanto-axial region, sequela of fracture