Question 1

What is ICD-10 code M48.01?

Accepted Answer

M48.01 is the ICD-10-CM diagnosis code for spinal stenosis, occipito-atlanto-axial region. Narrowing of the spinal canal in the upper neck region where the skull connects to the spine (occipito-atlanto-axial region). M48.01 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering spondylopathies (m45-m49).

M48.01 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28, V24, ESRD, or RxHCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

This is a rare location for stenosis; ensure documentation clearly indicates involvement at the skull-spine junction.

Question 2

Is M48.01 an HCC code?

Accepted Answer

M48.01 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

Question 3

Is M48.01 billable?

Accepted Answer

Yes. M48.01 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. M48.01 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

Which HCC does M48.01 map to under V28?

Accepted Answer

M48.01 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

Question 5

What RAF reference is published for M48.01?

Accepted Answer

M48.01 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

Question 6

What is the V28 vs V24 difference for M48.01?

Accepted Answer

M48.01 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

Question 7

What documentation supports M48.01?

Accepted Answer

This is a rare location for stenosis; ensure documentation clearly indicates involvement at the skull-spine junction May present with neck pain, headaches, or neurological symptoms in the upper extremities M48.01 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

HCC Buddy Code Card

M48.01

Is M48.01 an HCC code?

Get the V28 mapping + MEAT cheat sheet

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Work M48.01 in HCC Buddy

M48.01 ICD-10-CM Code: Spinal stenosis, occipito-atlanto-axial region

HCC Buddy Code Card

M48.01

Is M48.01 an HCC code?

Get the V28 mapping + MEAT cheat sheet

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Work M48.01 in HCC Buddy