M48.54XG — Collapsed vertebra, not elsewhere classified, thoracic region, subsequent encounter for fracture with delayed healing
M48.54XG is a billable, specific ICD-10-CM code for collapsed vertebra, not elsewhere classified, thoracic region, subsequent encounter for fracture with delayed healing. It is valid for submission on a claim.
7th character "G" — subsequent encounter for fracture with delayed healing
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 M48.54XG
These are not written on M48.54XG, but they bind it: a note on a category applies to every code beneath it. Billing M48.54XG 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 M48.54XG
These codes carry an Excludes1 note pointing at M48.54XG. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M48.54XG alone.
- G55Nerve root and plexus compressions in diseases classified elsewhere
Risk adjustment
M48.54XG 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
M48.54XG is named in 7 Medicare coverage policies — 0 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
M48.54XG 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 M48.54. If M48.54XG is not quite right, the correct code is usually one of these.
- M48.54XACollapsed vertebra, not elsewhere classified, thoracic region, initial encounter for fracture
- M48.54XDCollapsed vertebra, not elsewhere classified, thoracic region, subsequent encounter for fracture with routine healing
- M48.54XSCollapsed vertebra, not elsewhere classified, thoracic region, sequela of fracture
Questions about M48.54XG
- Is M48.54XG a billable ICD-10-CM code?
- Yes. M48.54XG is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M48.54XG 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 M48.54XG?
- M48.54XG 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 M48.54XG (M48.5) and apply to it just the same.