Is M48.40 a billable ICD-10-CM code?

No. M48.40 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M48.40 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Spondylopathies (M45-M49).

M48.40

M48.40 — Fatigue fracture of vertebra, site unspecified

Non-billable headerICD-10-CM

M48.40 is a non-billable header ICD-10-CM code for fatigue fracture of vertebra, site unspecified. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

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

A: initial encounter for fracture
D: subsequent encounter for fracture with routine healing
G: subsequent encounter for fracture with delayed healing
S: sequela of fracture

Risk adjustment

M48.40 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

How M48.40 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to M48.40.

Fracture, traumatic›fatigue›vertebra

Code to one of these instead M48.40

4 child codes. Green means billable.

Related codes at this level

Codes that share M48.4. If M48.40 is not quite right, the correct code is usually one of these.

Questions about M48.40

Is M48.40 a billable ICD-10-CM code?: No. M48.40 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M48.40 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Spondylopathies (M45-M49).