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M48.45XG ICD-10-CM Code: Fatigue fracture of vertebra, thoracolumbar region, subsequent encounter for fracture with delayed 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, thoracolumbar region, subsequent encounter for fracture with delayed healing is a billable ICD-10-CM diagnosis code (M48.45G).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for M48.45XG 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 M48.45XG 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.

Relationships & Classification

Other codes that name M48.45XG or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

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

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

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.

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.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Stress fracture, subsequent encounter).

M48.40XG — Fatigue fracture of vertebra, site unspecified, subsequent encounter for fracture with delayed healing, 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, M48.42XD — Fatigue fracture of vertebra, cervical region, subsequent encounter for fracture with routine healing, M48.42XG — Fatigue fracture of vertebra, cervical region, subsequent encounter for fracture with delayed healing, M48.43XD — Fatigue fracture of vertebra, cervicothoracic region, subsequent encounter for fracture with routine healing, M48.43XG — Fatigue fracture of vertebra, cervicothoracic region, subsequent encounter for fracture with delayed healing, M48.44XD — Fatigue fracture of vertebra, thoracic region, subsequent encounter for fracture with routine healing, M48.44XG — Fatigue fracture of vertebra, thoracic region, subsequent encounter for fracture with delayed healing, M48.45XD — Fatigue fracture of vertebra, thoracolumbar region, subsequent encounter for fracture with routine healing, M48.46XD — Fatigue fracture of vertebra, lumbar region, subsequent encounter for fracture with routine healing, M48.46XG — Fatigue fracture of vertebra, lumbar region, subsequent encounter for fracture with delayed healing, M48.47XD — Fatigue fracture of vertebra, lumbosacral region, subsequent encounter for fracture with routine healing, M48.47XG — Fatigue fracture of vertebra, lumbosacral region, subsequent encounter for fracture with delayed healing, M48.48XD — Fatigue fracture of vertebra, sacral and sacrococcygeal region, subsequent encounter for fracture with routine healing, M48.48XG — Fatigue fracture of vertebra, sacral and sacrococcygeal region, subsequent encounter for fracture with delayed healing, M48.50XD — Collapsed vertebra, not elsewhere classified, site unspecified, subsequent encounter for fracture with routine healing, M48.50XG — Collapsed vertebra, not elsewhere classified, site unspecified, subsequent encounter for fracture with delayed healing, M48.51XD — Collapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, subsequent encounter for fracture with routine healing, M48.51XG — Collapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, subsequent encounter for fracture with delayed healing, +167 more

Contextual Map

Every relationship of M48.45XG 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]
  • M48.41XG — Fatigue fracture of vertebra, occipito-atlanto-axial region, subsequent encounter for fracture with delayed healing [Sibling]
  • M48.41XS — Fatigue fracture of vertebra, occipito-atlanto-axial region, sequela of fracture [Sibling]
  • M48.42 — Fatigue fracture of vertebra, cervical region [Sibling]
  • M48.42XA — Fatigue fracture of vertebra, cervical region, initial encounter for fracture [Sibling]
  • M48.42XD — Fatigue fracture of vertebra, cervical region, subsequent encounter for fracture with routine healing [Sibling]
  • M48.42XG — Fatigue fracture of vertebra, cervical region, subsequent encounter for fracture with delayed healing [Sibling]
  • M48.42XS — Fatigue fracture of vertebra, cervical region, sequela of fracture [Sibling]
  • and 32 more

Frequently Asked Questions (FAQ) & Clinical Guidance

Does M48.45XG 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 M48.45XG in its code family, with their registry titles.

  • M48.44XG — Fatigue fracture of vertebra, thoracic region, subsequent encounter for fracture with delayed healing
  • M48.44XS — Fatigue fracture of vertebra, thoracic region, sequela of fracture
  • M48.45 — Fatigue fracture of vertebra, thoracolumbar region
  • M48.45XA — Fatigue fracture of vertebra, thoracolumbar region, initial encounter for fracture
  • M48.45XD — Fatigue fracture of vertebra, thoracolumbar region, subsequent encounter for fracture with routine healing
  • M48.45XS — Fatigue fracture of vertebra, thoracolumbar region, sequela of fracture
  • M48.46 — Fatigue fracture of vertebra, lumbar region
  • M48.46XA — Fatigue fracture of vertebra, lumbar region, initial encounter for fracture
  • M48.46XD — Fatigue fracture of vertebra, lumbar region, subsequent encounter for fracture with routine healing
  • M48.46XG — Fatigue fracture of vertebra, lumbar region, subsequent encounter for fracture with delayed healing

View all codes in the M48 family