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ICD-10 Guide
ICD-10 CodesM48.44

M48.44

Billable

Fatigue fracture of vertebra, thoracic region

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

Code Description

ICD-10 M48.44 is a billable code used to indicate a diagnosis of fatigue fracture of vertebra, thoracic region.

Key Diagnostic Point:

A fatigue fracture of the vertebra in the thoracic region is a type of stress fracture that occurs due to repetitive mechanical stress on the vertebrae, often seen in individuals with underlying conditions such as spondylopathies, ankylosing spondylitis, or spinal stenosis. These fractures can result from chronic conditions that weaken the vertebral structure, leading to microtrauma and eventual fracture. Patients may present with localized pain, which can be exacerbated by movement or certain positions. Diagnosis typically involves imaging studies such as X-rays or MRI to confirm the presence of a fracture and assess any associated conditions. Management may include conservative treatment options like rest, physical therapy, and pain management, or surgical intervention in more severe cases. Understanding the underlying conditions contributing to the fatigue fracture is crucial for effective treatment and prevention of recurrence.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between fatigue fractures and other types of vertebral fractures.
  • Understanding the impact of underlying conditions like ankylosing spondylitis on fracture risk.
  • The need for comprehensive documentation of patient history and imaging results.
  • Variability in clinical presentation and management strategies based on patient demographics.

Audit Risk Factors

  • Inadequate documentation of the underlying condition leading to the fracture.
  • Failure to specify the exact location of the fracture.
  • Misclassification of the fracture type (fatigue vs. acute).
  • Lack of imaging results in the medical record.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, patient history, and treatment plans.

Common Clinical Scenarios

Patients with chronic back pain and a history of repetitive stress injuries.

Billing Considerations

Documentation must clearly outline the relationship between the underlying condition and the fracture.

Rheumatology

Documentation Requirements

Comprehensive assessment of inflammatory markers and patient history.

Common Clinical Scenarios

Patients with ankylosing spondylitis presenting with back pain.

Billing Considerations

Must document the impact of inflammatory conditions on bone health.

Coding Guidelines

Inclusion Criteria

Use M48.44 When
  • According to ICD
  • 10 guidelines, M48
  • 44 should be used when a fatigue fracture is confirmed in the thoracic region
  • It is important to document the cause of the fracture and any relevant comorbidities

Exclusion Criteria

Do NOT use M48.44 When
  • Exclusion criteria include acute fractures and fractures due to trauma

Related ICD-10 Codes

Related CPT Codes

73030CPT Code

Radiologic examination, spine, thoracic, two views

Clinical Scenario

Used to confirm the presence of a fatigue fracture.

Documentation Requirements

Radiology report must be included.

Specialty Considerations

Orthopedic specialists should ensure imaging is comprehensive.

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. M48.44 provides a clear distinction from acute fractures, which is essential for appropriate management and treatment planning.

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. M48.44 provides a clear distinction from acute fractures, which is essential for appropriate management and treatment planning.

Reimbursement & Billing Impact

reimbursement processes. M48.44 provides a clear distinction from acute fractures, which is essential for appropriate management and treatment planning.

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 difference between a fatigue fracture and an acute fracture?

A fatigue fracture occurs due to repetitive stress over time, while an acute fracture results from a sudden injury or trauma. Proper documentation is essential to differentiate between the two.