M48.41XS — Fatigue fracture of vertebra, occipito-atlanto-axial region, sequela of fracture
M48.41XS is a billable, specific ICD-10-CM code for fatigue fracture of vertebra, occipito-atlanto-axial region, sequela of fracture. It is valid for submission on a claim.
7th character "S" — sequela of fracture
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
M48.41XS 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.
Medicare coverage
M48.41XS is named in 13 Medicare coverage policies — 7 listing it as supporting medical necessity, and 6 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59434Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
Related codes at this level
Codes that share M48.41. If M48.41XS is not quite right, the correct code is usually one of these.
- M48.41XAFatigue fracture of vertebra, occipito-atlanto-axial region, initial encounter for fracture
- M48.41XDFatigue fracture of vertebra, occipito-atlanto-axial region, subsequent encounter for fracture with routine healing
- M48.41XGFatigue fracture of vertebra, occipito-atlanto-axial region, subsequent encounter for fracture with delayed healing
Questions about M48.41XS
- Is M48.41XS a billable ICD-10-CM code?
- Yes. M48.41XS is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M48.41XS sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Spondylopathies (M45-M49).