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ICD-10 Guide
ICD-10 CodesM48.47

M48.47

Billable

Fatigue fracture of vertebra, lumbosacral region

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M48.47 is a billable code used to indicate a diagnosis of fatigue fracture of vertebra, lumbosacral region.

Key Diagnostic Point:

A fatigue fracture of the vertebra in the lumbosacral region occurs due to repetitive stress or overuse, leading to microtrauma that surpasses the bone's ability to repair itself. This condition is often seen in individuals who engage in high-impact activities or those with underlying conditions that weaken bone integrity, such as osteoporosis or inflammatory spine diseases. The lumbosacral region, which includes the lower back and sacrum, is particularly susceptible due to its weight-bearing role and mobility. Symptoms may include localized pain, tenderness, and potential neurological deficits if the fracture affects surrounding structures. Diagnosis typically involves imaging studies such as X-rays, MRI, or CT scans to confirm the presence of a fracture and assess any associated complications. Management may include conservative measures like rest, physical therapy, and pain management, or surgical intervention in severe cases. Understanding the relationship between fatigue fractures and conditions like ankylosing spondylitis or spinal stenosis is crucial, as these conditions can predispose patients to fractures due to altered biomechanics and reduced bone density.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between fatigue fractures and other types of vertebral fractures.
  • Understanding the impact of comorbid conditions like ankylosing spondylitis.
  • Interpreting imaging results accurately to confirm diagnosis.
  • Documenting the patient's history of repetitive stress or underlying conditions.

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury.
  • Failure to document associated conditions like osteoporosis or spondylitis.
  • Lack of imaging results to support the diagnosis.
  • Misclassification of fracture type.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, patient history, and treatment plans.

Common Clinical Scenarios

Patients presenting with lower back pain after repetitive activities or trauma.

Billing Considerations

Consideration of surgical options and rehabilitation protocols.

Rheumatology

Documentation Requirements

Comprehensive assessment of inflammatory markers and patient history of autoimmune conditions.

Common Clinical Scenarios

Patients with ankylosing spondylitis experiencing new onset back pain.

Billing Considerations

Monitoring for progression of underlying inflammatory conditions.

Coding Guidelines

Inclusion Criteria

Use M48.47 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the fracture type and any associated conditions
  • Include details about the mechanism of injury and any relevant imaging findings

Exclusion Criteria

Do NOT use M48.47 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Percutaneous vertebroplasty

Clinical Scenario

Used in cases of vertebral compression fractures.

Documentation Requirements

Indicate the reason for the procedure and imaging findings.

Specialty Considerations

Orthopedic specialists should document the patient's history and treatment plan.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fatigue fractures, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of patient outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fatigue fractures, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of patient outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of patient outcomes and resource allocation.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common causes of fatigue fractures in the lumbosacral region?

Common causes include repetitive stress from physical activities, underlying conditions like osteoporosis or ankylosing spondylitis, and trauma.