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).

What cannot be coded together with M48.40?

M48.40 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M48.40 (M48.4) and apply to it just the same.

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

Excludes1 inherited from the categories above M48.40

These are not written on M48.40, but they bind it: a note on a category applies to every code beneath it. Billing M48.40 with anything listed here is a denial.

Written on M48.4 — Fatigue fracture of vertebra

pathological fracture NOS (M84.4-)
pathological fracture of vertebra due to neoplasm (M84.58)
pathological fracture of vertebra due to other diagnosis (M84.68)
pathological fracture of vertebra due to osteoporosis (M80.-)
traumatic fracture of vertebrae (S12.0-S12.3-, S22.0-, S32.0-)

Other codes that can never be billed with M48.40

These codes carry an Excludes1 note pointing at M48.40. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M48.40 alone.

G55Nerve root and plexus compressions in diseases classified elsewhere

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 history

M48.40 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

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).
What cannot be coded together with M48.40?: M48.40 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M48.40 (M48.4) and apply to it just the same.