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M48.51XS ICD-10-CM Code: Collapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, sequela of fracture

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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Spondylopathies (M45-M49)

M48.51XS

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Collapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, sequela of fracture

Collapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, sequela of fracture

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
M4851XSpondylopathies (M45-M49)
M48.51XSCollapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, sequela of fracture

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M48.51XS in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M48.51XS in this effective period.

Related Child Codes

Official
M48.51XACollapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, initial encounter for fracture
M48.51XDCollapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, subsequent encounter for fracture with routine healing
M48.51XGCollapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, subsequent encounter for fracture with delayed healing

Includes

Official

ICD-10-CM does not list Includes notes for M48.51XS in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M48.51XS in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M48.51XS in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M48.51XS in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M48.51XS in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is M48.51XS an HCC code?

No. M48.51XS is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

M48.51XS is the ICD-10-CM diagnosis code for collapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, sequela of fracture. M48.51XS 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).

M48.51XS is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

M48.51XS is a billable ICD-10-CM code that can be reported on claims but does not currently contribute to a Medicare Advantage member's RAF score under any CMS risk adjustment model (V28, V24, ESRD, or RxHCC). Coders reviewing M48.51XS should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M48.51XS sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

M48.51XSCollapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, sequela of fracture
M48.51XSCollapsed vertebra, not elsewhere classified, occipito-atlanto-axial region, sequela of fracture

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