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ICD-10 Guide
ICD-10 CodesM48.57

M48.57

Billable

Collapsed vertebra, not elsewhere classified, lumbosacral region

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

Code Description

ICD-10 M48.57 is a billable code used to indicate a diagnosis of collapsed vertebra, not elsewhere classified, lumbosacral region.

Key Diagnostic Point:

Collapsed vertebrae in the lumbosacral region can occur due to various underlying conditions, including spondylopathies, ankylosing spondylitis, and inflammatory spine conditions. These conditions can lead to structural changes in the vertebrae, resulting in a loss of height or integrity of the vertebral body. In ankylosing spondylitis, for instance, chronic inflammation can lead to fusion of the vertebrae and subsequent collapse. Spinal stenosis, characterized by narrowing of the spinal canal, can also contribute to vertebral collapse due to increased pressure on the vertebrae. The lumbosacral region is particularly susceptible to these changes due to its weight-bearing function and mobility. Diagnosis typically involves imaging studies such as X-rays or MRI, which can reveal vertebral deformities and associated complications. Treatment may include pain management, physical therapy, and in severe cases, surgical intervention. Accurate coding of this condition is essential for proper reimbursement and to reflect the complexity of the patient's clinical picture.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various causes of vertebral collapse
  • Need for comprehensive documentation of underlying conditions
  • Potential for multiple co-existing diagnoses
  • Variability in clinical presentation and severity

Audit Risk Factors

  • Inadequate documentation of the cause of collapse
  • Failure to document co-existing conditions
  • Lack of imaging results in the medical record
  • Misinterpretation of clinical findings

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed history of the patient's spine condition, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with back pain, history of trauma, or chronic inflammatory conditions.

Billing Considerations

Ensure that all relevant imaging studies are included in the documentation to support the diagnosis.

Rheumatology

Documentation Requirements

Comprehensive assessment of inflammatory markers, patient history, and response to treatment.

Common Clinical Scenarios

Patients with known inflammatory spine diseases presenting with new or worsening symptoms.

Billing Considerations

Documenting the progression of the disease and its impact on the patient's functional status is crucial.

Coding Guidelines

Inclusion Criteria

Use M48.57 When
  • According to ICD
  • 10 guidelines, M48
  • 57 should be used when the vertebral collapse is not classified elsewhere
  • Coders must ensure that the documentation supports the diagnosis and that all relevant conditions are coded appropriately
  • It is essential to follow the official coding guidelines for specificity and accuracy

Exclusion Criteria

Do NOT use M48.57 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Vertebroplasty

Clinical Scenario

Used for patients with vertebral collapse to stabilize the vertebra.

Documentation Requirements

Pre-operative imaging and assessment of the vertebral collapse.

Specialty Considerations

Orthopedic surgeons must document the indication for the procedure clearly.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like vertebral collapse, improving the accuracy of patient records and reimbursement processes. M48.57 provides a clear classification for cases that do not fit into other categories, enhancing clinical understanding and management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like vertebral collapse, improving the accuracy of patient records and reimbursement processes. M48.57 provides a clear classification for cases that do not fit into other categories, enhancing clinical understanding and management.

Reimbursement & Billing Impact

reimbursement processes. M48.57 provides a clear classification for cases that do not fit into other categories, enhancing clinical understanding and management.

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 is the primary cause of a collapsed vertebra?

Collapsed vertebrae can result from various factors, including trauma, osteoporosis, inflammatory diseases like ankylosing spondylitis, and degenerative conditions. Accurate diagnosis is crucial for appropriate treatment.