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v1.0.0
ICD-10 Guide
ICD-10 CodesM48.5

M48.5

Billable

Collapsed vertebra, not elsewhere classified

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

Code Description

ICD-10 M48.5 is a billable code used to indicate a diagnosis of collapsed vertebra, not elsewhere classified.

Key Diagnostic Point:

Collapsed vertebrae, also known as vertebral compression fractures, occur when the vertebrae in the spine become weakened and collapse under pressure. This condition is often associated with osteoporosis, trauma, or malignancy. In the context of spondylopathies, conditions such as ankylosing spondylitis can lead to structural changes in the spine, increasing the risk of vertebral collapse. Spinal stenosis, characterized by narrowing of the spinal canal, can also contribute to vertebral instability. Inflammatory spine conditions may exacerbate the risk of vertebral collapse due to chronic inflammation and weakening of the vertebral bodies. Accurate diagnosis often involves imaging studies such as X-rays, MRI, or CT scans to assess the extent of vertebral collapse and rule out other underlying conditions. Treatment may include pain management, physical therapy, or surgical interventions, depending on the severity and underlying cause of the collapse.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of vertebral collapse (traumatic vs. pathological)
  • Understanding the underlying conditions contributing to vertebral collapse
  • Need for precise documentation of the cause and location of the collapse
  • Potential for co-existing conditions that may complicate coding

Audit Risk Factors

  • Inadequate documentation of the cause of vertebral collapse
  • Failure to specify the location of the collapsed vertebra
  • Misclassification of the type of vertebral collapse
  • Lack of supporting imaging documentation

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed imaging reports, treatment plans, and notes on the patient's history of trauma or osteoporosis.

Common Clinical Scenarios

Patients presenting with back pain and a history of osteoporosis or recent trauma.

Billing Considerations

Ensure that the cause of the collapse is clearly documented to support the use of M48.5.

Rheumatology

Documentation Requirements

Comprehensive assessment of inflammatory markers, imaging studies, and history of inflammatory spine conditions.

Common Clinical Scenarios

Patients with ankylosing spondylitis presenting with new onset back pain and vertebral collapse.

Billing Considerations

Document the relationship between inflammatory conditions and vertebral collapse to justify coding.

Coding Guidelines

Inclusion Criteria

Use M48.5 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the cause and location of the vertebral collapse
  • Include any relevant history of trauma, malignancy, or inflammatory conditions

Exclusion Criteria

Do NOT use M48.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

22551CPT Code

Vertebroplasty

Clinical Scenario

Used in cases of vertebral collapse to stabilize the vertebra.

Documentation Requirements

Pre-operative imaging and assessment of vertebral stability.

Specialty Considerations

Orthopedic surgeons must document the indication for vertebroplasty clearly.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of vertebral conditions, improving the accuracy of diagnoses and treatment tracking. M48.5 provides a clear classification for collapsed vertebrae that may not fit into other categories.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of vertebral conditions, improving the accuracy of diagnoses and treatment tracking. M48.5 provides a clear classification for collapsed vertebrae that may not fit into other categories.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of vertebral conditions, improving the accuracy of diagnoses and treatment tracking. M48.5 provides a clear classification for collapsed vertebrae that may not fit into other categories.

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?

The primary cause of a collapsed vertebra is often osteoporosis, but it can also result from trauma, malignancy, or inflammatory conditions.

How is a collapsed vertebra diagnosed?

A collapsed vertebra is typically diagnosed through imaging studies such as X-rays, MRI, or CT scans that reveal vertebral height loss.

What treatments are available for a collapsed vertebra?

Treatment options may include pain management, physical therapy, vertebroplasty, or surgical intervention depending on the severity and underlying cause.