Other spondylopathies
In Spondylopathies (M45-M49), chapter 13: Diseases of the Musculoskeletal System and Connective Tissue
119 billable codes under M48: 18 are a CC; 18 map to HCC 93 (Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders), HCC 401 (Vertebral Fractures without Spinal Cord Injury).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.
Advertisements
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
Covers site and laterality, acute injury versus chronic musculoskeletal conditions, 7th characters for pathologic fractures, osteoporosis with or without current fracture, and multisystem inflammatory syndrome.
- Site and laterality (page 60)
- Acute traumatic versus chronic or recurrent musculoskeletal conditions (page 61)
- Coding of Pathologic Fractures (page 61)
- Osteoporosis (page 61)
- Multisystem Inflammatory Syndrome (page 62)
All codes under M48
M48 can't be used on a claim. Pick a billable code below; grey headings group them.
- M48.0Spinal stenosis
- M48.00Spinal stenosis, site unspecified
- M48.01Spinal stenosis, occipito-atlanto-axial region
- M48.02Spinal stenosis, cervical region
- M48.03Spinal stenosis, cervicothoracic region
- M48.04Spinal stenosis, thoracic region
- M48.05Spinal stenosis, thoracolumbar region
- M48.06Spinal stenosis, lumbar region
- M48.061Spinal stenosis, lumbar region without neurogenic claudication
- M48.062Spinal stenosis, lumbar region with neurogenic claudication
- M48.07Spinal stenosis, lumbosacral region
- M48.08Spinal stenosis, sacral and sacrococcygeal region
- M48.1Ankylosing hyperostosis [Forestier]
- M48.10Ankylosing hyperostosis [Forestier], site unspecified
- M48.11Ankylosing hyperostosis [Forestier], occipito-atlanto-axial region
- M48.12Ankylosing hyperostosis [Forestier], cervical region
- M48.13Ankylosing hyperostosis [Forestier], cervicothoracic region
- M48.14Ankylosing hyperostosis [Forestier], thoracic region
- M48.15Ankylosing hyperostosis [Forestier], thoracolumbar region
- M48.16Ankylosing hyperostosis [Forestier], lumbar region
- M48.17Ankylosing hyperostosis [Forestier], lumbosacral region
- M48.18Ankylosing hyperostosis [Forestier], sacral and sacrococcygeal region
- M48.19Ankylosing hyperostosis [Forestier], multiple sites in spine
- M48.2Kissing spine
- M48.20Kissing spine, site unspecified
- M48.21Kissing spine, occipito-atlanto-axial region
- M48.22Kissing spine, cervical region
- M48.23Kissing spine, cervicothoracic region
- M48.24Kissing spine, thoracic region
- M48.25Kissing spine, thoracolumbar region
- M48.26Kissing spine, lumbar region
- M48.27Kissing spine, lumbosacral region
- M48.3Traumatic spondylopathy
- M48.30Traumatic spondylopathy, site unspecified
- M48.31Traumatic spondylopathy, occipito-atlanto-axial region
- M48.32Traumatic spondylopathy, cervical region
- M48.33Traumatic spondylopathy, cervicothoracic region
- M48.34Traumatic spondylopathy, thoracic region
- M48.35Traumatic spondylopathy, thoracolumbar region
- M48.36Traumatic spondylopathy, lumbar region
- M48.37Traumatic spondylopathy, lumbosacral region
- M48.38Traumatic spondylopathy, sacral and sacrococcygeal region
- M48.4Fatigue fracture of vertebra
- M48.40Fatigue fracture of vertebra, site unspecified
- M48.40XAFatigue fracture of vertebra, site unspecified, initial encounter for fracture
- M48.40XDFatigue fracture of vertebra, site unspecified, subsequent encounter for fracture with routine healing
- M48.40XGFatigue fracture of vertebra, site unspecified, subsequent encounter for fracture with delayed healing
- M48.40XSFatigue fracture of vertebra, site unspecified, sequela of fracture
- M48.41Fatigue fracture of vertebra, occipito-atlanto-axial region
- 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
- M48.41XSFatigue fracture of vertebra, occipito-atlanto-axial region, sequela of fracture
- M48.42Fatigue fracture of vertebra, cervical region
- M48.42XAFatigue fracture of vertebra, cervical region, initial encounter for fracture
- M48.42XDFatigue fracture of vertebra, cervical region, subsequent encounter for fracture with routine healing
- M48.42XGFatigue fracture of vertebra, cervical region, subsequent encounter for fracture with delayed healing
- M48.42XSFatigue fracture of vertebra, cervical region, sequela of fracture
- M48.43Fatigue fracture of vertebra, cervicothoracic region
- M48.43XAFatigue fracture of vertebra, cervicothoracic region, initial encounter for fracture
- M48.43XDFatigue fracture of vertebra, cervicothoracic region, subsequent encounter for fracture with routine healing
- M48.43XGFatigue fracture of vertebra, cervicothoracic region, subsequent encounter for fracture with delayed healing
- M48.43XSFatigue fracture of vertebra, cervicothoracic region, sequela of fracture
- M48.44Fatigue fracture of vertebra, thoracic region
- M48.44XAFatigue fracture of vertebra, thoracic region, initial encounter for fracture
- M48.44XDFatigue fracture of vertebra, thoracic region, subsequent encounter for fracture with routine healing
- M48.44XGFatigue fracture of vertebra, thoracic region, subsequent encounter for fracture with delayed healing
- M48.44XSFatigue fracture of vertebra, thoracic region, sequela of fracture
- M48.45Fatigue fracture of vertebra, thoracolumbar region
- M48.45XAFatigue fracture of vertebra, thoracolumbar region, initial encounter for fracture
- M48.45XDFatigue fracture of vertebra, thoracolumbar region, subsequent encounter for fracture with routine healing
- M48.45XGFatigue fracture of vertebra, thoracolumbar region, subsequent encounter for fracture with delayed healing
- M48.45XSFatigue fracture of vertebra, thoracolumbar region, sequela of fracture
- M48.46Fatigue fracture of vertebra, lumbar region
- M48.46XAFatigue fracture of vertebra, lumbar region, initial encounter for fracture
- M48.46XDFatigue fracture of vertebra, lumbar region, subsequent encounter for fracture with routine healing
- M48.46XGFatigue fracture of vertebra, lumbar region, subsequent encounter for fracture with delayed healing
- M48.46XSFatigue fracture of vertebra, lumbar region, sequela of fracture
- M48.47Fatigue fracture of vertebra, lumbosacral region
- M48.47XAFatigue fracture of vertebra, lumbosacral region, initial encounter for fracture
- M48.47XDFatigue fracture of vertebra, lumbosacral region, subsequent encounter for fracture with routine healing
- M48.47XGFatigue fracture of vertebra, lumbosacral region, subsequent encounter for fracture with delayed healing
- M48.47XSFatigue fracture of vertebra, lumbosacral region, sequela of fracture
- M48.48Fatigue fracture of vertebra, sacral and sacrococcygeal region
- M48.48XAFatigue fracture of vertebra, sacral and sacrococcygeal region, initial encounter for fracture
- M48.48XDFatigue fracture of vertebra, sacral and sacrococcygeal region, subsequent encounter for fracture with routine healing
- M48.48XGFatigue fracture of vertebra, sacral and sacrococcygeal region, subsequent encounter for fracture with delayed healing
- M48.48XSFatigue fracture of vertebra, sacral and sacrococcygeal region, sequela of fracture
- M48.5Collapsed vertebra, not elsewhere classified
- M48.50Collapsed vertebra, not elsewhere classified, site unspecified
- M48.50XACollapsed vertebra, not elsewhere classified, site unspecified, initial encounter for fracture
- 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
- M48.51Collapsed vertebra, not elsewhere classified, occipito-atlanto-axial region
- M48.51XACollapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, initial encounter for fracture
- M48.51XDCollapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, subsequent encounter for fracture with routine healing
- M48.51XGCollapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, subsequent encounter for fracture with delayed healing
- M48.51XSCollapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, sequela of fracture
- M48.52Collapsed vertebra, not elsewhere classified, cervical region
- M48.52XACollapsed vertebra, not elsewhere classified, cervical region, initial encounter for fracture
- 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
- M48.53Collapsed vertebra, not elsewhere classified, cervicothoracic region
- M48.53XACollapsed vertebra, not elsewhere classified, cervicothoracic region, initial encounter for fracture
- M48.53XDCollapsed vertebra, not elsewhere classified, cervicothoracic region, subsequent encounter for fracture with routine healing
- M48.53XGCollapsed vertebra, not elsewhere classified, cervicothoracic region, subsequent encounter for fracture with delayed healing
- M48.53XSCollapsed vertebra, not elsewhere classified, cervicothoracic region, sequela of fracture
- M48.54Collapsed vertebra, not elsewhere classified, thoracic region
- 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
- M48.54XGCollapsed vertebra, not elsewhere classified, thoracic region, subsequent encounter for fracture with delayed healing
- M48.54XSCollapsed vertebra, not elsewhere classified, thoracic region, sequela of fracture
- M48.55Collapsed vertebra, not elsewhere classified, thoracolumbar region
- M48.55XACollapsed vertebra, not elsewhere classified, thoracolumbar region, initial encounter for fracture
- M48.55XDCollapsed vertebra, not elsewhere classified, thoracolumbar region, subsequent encounter for fracture with routine healing
- M48.55XGCollapsed vertebra, not elsewhere classified, thoracolumbar region, subsequent encounter for fracture with delayed healing
- M48.55XSCollapsed vertebra, not elsewhere classified, thoracolumbar region, sequela of fracture
- M48.56Collapsed vertebra, not elsewhere classified, lumbar region
- M48.56XACollapsed vertebra, not elsewhere classified, lumbar region, initial encounter for fracture
- M48.56XDCollapsed vertebra, not elsewhere classified, lumbar region, subsequent encounter for fracture with routine healing
- M48.56XGCollapsed vertebra, not elsewhere classified, lumbar region, subsequent encounter for fracture with delayed healing
- M48.56XSCollapsed vertebra, not elsewhere classified, lumbar region, sequela of fracture
- M48.57Collapsed vertebra, not elsewhere classified, lumbosacral region
- M48.57XACollapsed vertebra, not elsewhere classified, lumbosacral region, initial encounter for fracture
- M48.57XDCollapsed vertebra, not elsewhere classified, lumbosacral region, subsequent encounter for fracture with routine healing
- M48.57XGCollapsed vertebra, not elsewhere classified, lumbosacral region, subsequent encounter for fracture with delayed healing
- M48.57XSCollapsed vertebra, not elsewhere classified, lumbosacral region, sequela of fracture
- M48.58Collapsed vertebra, not elsewhere classified, sacral and sacrococcygeal region
- M48.58XACollapsed vertebra, not elsewhere classified, sacral and sacrococcygeal region, initial encounter for fracture
- M48.58XDCollapsed vertebra, not elsewhere classified, sacral and sacrococcygeal region, subsequent encounter for fracture with routine healing
- M48.58XGCollapsed vertebra, not elsewhere classified, sacral and sacrococcygeal region, subsequent encounter for fracture with delayed healing
- M48.58XSCollapsed vertebra, not elsewhere classified, sacral and sacrococcygeal region, sequela of fracture
- M48.8Other specified spondylopathies
- M48.8XOther specified spondylopathies
- M48.8X1Other specified spondylopathies, occipito-atlanto-axial region
- M48.8X2Other specified spondylopathies, cervical region
- M48.8X3Other specified spondylopathies, cervicothoracic region
- M48.8X4Other specified spondylopathies, thoracic region
- M48.8X5Other specified spondylopathies, thoracolumbar region
- M48.8X6Other specified spondylopathies, lumbar region
- M48.8X7Other specified spondylopathies, lumbosacral region
- M48.8X8Other specified spondylopathies, sacral and sacrococcygeal region
- M48.8X9Other specified spondylopathies, site unspecified
- M48.9Spondylopathy, unspecified
M48 MS-DRGs
As the principal diagnosis, the billable codes under M48 group to these 13 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 551 Medical Back Problems with MCC (56 of 119 codes)
- DRG 552 Medical Back Problems without MCC (56 of 119 codes)
- DRG 559 Aftercare, Musculoskeletal System and Connective Tissue with MCC (36 of 119 codes)
- DRG 560 Aftercare, Musculoskeletal System and Connective Tissue with CC (36 of 119 codes)
- DRG 561 Aftercare, Musculoskeletal System and Connective Tissue without CC/MCC (36 of 119 codes)
- DRG 542 Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with MCC (18 of 119 codes)
- DRG 543 Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with CC (18 of 119 codes)
- DRG 544 Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy without CC/MCC (18 of 119 codes)
- DRG 545 Connective Tissue Disorders with MCC (9 of 119 codes)
- DRG 546 Connective Tissue Disorders with CC (9 of 119 codes)
- DRG 547 Connective Tissue Disorders without CC/MCC (9 of 119 codes)
- DRG 791 Prematurity with Major Problems (9 of 119 codes)
- DRG 793 Full Term Neonate with Major Problems (9 of 119 codes)
Other codes that refer to M48
Notes on these codes point to M48.
- G55 Excludes1: nerve root compression (due to) (in) spondylopathies (M46.-, M48.-)
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Spine Injuries and Disorders
Your backbone, or spine, is made up of 26 bone discs called vertebrae. The vertebrae protect your spinal cord and allow you to stand and bend. A number of problems can change the structure of the spine or damage the vertebrae and surrounding tissue. They include:
Read more about spine injuries and disorders on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.
