2025 ICD-10-CM code M48.5
(Valid) Effective Date: N/A Dorsopathies - Spondylopathies (M45-M49) Diseases of the musculoskeletal system and connective tissue (M00-M99) Feed
Collapsed vertebra, not elsewhere classified.
The ICD-10-CM code M48.5 may be used with a 7th character to specify the encounter (initial, subsequent, sequela).Refer to official ICD-10-CM guidelines for correct 7th character usage.
Medical necessity is established by the presence of signs, symptoms, and diagnostic evidence supporting the diagnosis of a collapsed vertebra. The documentation should link the collapsed vertebra to the patient's symptoms and functional limitations.
Physicians diagnose collapsed vertebrae based on patient history, physical exam, bone density tests, and imaging studies (X-ray, MRI, CT). Treatment may include physical therapy, bracing, pain medication (NSAIDs, opioid analgesics), bone strengthening medications, rest, and in severe cases, surgery (vertebroplasty or kyphoplasty).
In simple words: A collapsed vertebra means one of the bones in your spine has broken and lost its height, kind of like a crushed can. This can happen because of weakened bones (like with osteoporosis), an injury, or sometimes even cancer. It can cause back pain and make it harder to stand up straight.
This code represents a collapsed vertebra that is not classified elsewhere in the ICD-10-CM. This condition often involves a compression fracture where the vertebra collapses, often due to osteoporosis, trauma, or other underlying conditions.It includes conditions like compression fracture NOS, wedging of vertebra NOS.
Example 1: A 65-year-old female with osteoporosis presents with sudden onset back pain after bending over. Imaging reveals a wedge compression fracture of the T12 vertebra.Code M48.5 is used., A 70-year-old male with a history of prostate cancer presents with back pain and loss of height. Imaging shows multiple collapsed vertebrae in the thoracic spine due to metastatic lesions. M48.5 would not be appropriate here. Code M84.58 is used to report the pathological fractures., A 25-year-old male is involved in a motor vehicle accident and sustains a burst fracture of the L1 vertebra. This would not be coded as M48.5. A code from the S32 category would be used.
Documentation should specify the type of collapsed vertebra, location, and any associated conditions such as osteoporosis or trauma.Details of the diagnostic workup (X-ray, MRI, CT scans, bone density tests) and treatment plan should be documented.
- Specialties:Orthopedics, physiatry, pain management, oncology (if related to cancer)
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Physician's Office,Independent Clinic