M48.50XA — Collapsed vertebra, not elsewhere classified, site unspecified, initial encounter for fracture
M48.50XA is a billable, specific ICD-10-CM code for collapsed vertebra, not elsewhere classified, site unspecified, initial encounter for fracture. It is valid for submission on a claim.
7th character "A" — initial encounter for fracture
The appropriate 7th character is to be added to each code from subcategory M48.5:
- 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 M48.50XA
These are not written on M48.50XA, but they bind it: a note on a category applies to every code beneath it. Billing M48.50XA with anything listed here is a denial.
Written on M48.5 — Collapsed vertebra, not elsewhere classified
- current injury - see Injury of spine, by body region
- fatigue fracture of vertebra (M48.4)
- 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.-)
- pathological fracture NOS (M84.4-)
- stress fracture of vertebra (M48.4-)
- traumatic fracture of vertebra (S12.-, S22.-, S32.-)
Other codes that can never be billed with M48.50XA
These codes carry an Excludes1 note pointing at M48.50XA. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M48.50XA alone.
- G55Nerve root and plexus compressions in diseases classified elsewhere
Risk adjustment
M48.50XA risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 401 Vertebral Fractures without Spinal Cord Injury0.522 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
M48.50XA is named in 12 Medicare coverage policies — 5 listing it as supporting medical necessity, and 7 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
- A58883Billing 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
Code history
M48.50XA has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share M48.50. If M48.50XA is not quite right, the correct code is usually one of these.
- M48.50XDCollapsed vertebra, not elsewhere classified, site unspecified, subsequent encounter for fracture with routine healing
- M48.50XGCollapsed vertebra, not elsewhere classified, site unspecified, subsequent encounter for fracture with delayed healing
- M48.50XSCollapsed vertebra, not elsewhere classified, site unspecified, sequela of fracture
Questions about M48.50XA
- Is M48.50XA a billable ICD-10-CM code?
- Yes. M48.50XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M48.50XA 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 M48.50XA?
- M48.50XA 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 M48.50XA (M48.5) and apply to it just the same.