M48.52XA — Collapsed vertebra, not elsewhere classified, cervical region, initial encounter for fracture
M48.52XA is a billable, specific ICD-10-CM code for collapsed vertebra, not elsewhere classified, cervical region, 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
Risk adjustment
M48.52XA 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
M48.52XA is named in 20 Medicare coverage policies — 14 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 M48.52. If M48.52XA is not quite right, the correct code is usually one of these.
- M48.52XDCollapsed vertebra, not elsewhere classified, cervical region, subsequent encounter for fracture with routine healing
- M48.52XGCollapsed vertebra, not elsewhere classified, cervical region, subsequent encounter for fracture with delayed healing
- M48.52XSCollapsed vertebra, not elsewhere classified, cervical region, sequela of fracture
Questions about M48.52XA
- Is M48.52XA a billable ICD-10-CM code?
- Yes. M48.52XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M48.52XA sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Spondylopathies (M45-M49).