M48.55XA
Collapsed vertebra, not elsewhere classified, thoracolumbar region, initial encounter for fracture
M48.55XA (also written M4855XA) is a billable ICD-10-CM diagnosis code for collapsed vertebra, not elsewhere classified, thoracolumbar region, initial encounter for fracture. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 119 codes in category M48 (Other spondylopathies). The Alphabetic Index lists it under 2 entries. Its 7th character, A, means initial encounter for fracture. Its coding notes include 8 Excludes1 entries and 10 Excludes2 entries.
7th character
Category M48.5 requires a 7th character. M48.55 has only 5 characters, so a placeholder X fills the 6th position.
Excludes1
Not coded here. The listed conditions generally should not be reported together.
- current injury - see Injury of spine, by body region
- fatigue fracture of vertebra (M48.4)
- pathological fracture of vertebra due to neoplasm (M84.58)
- pathological fracture of vertebra due to other diagnosis (M84.68)
- pathological fracture of vertebra due to osteoporosis (M80.-)
- pathological fracture NOS (M84.4-)
- stress fracture of vertebra (M48.4-)
- traumatic fracture of vertebra (S12.-, S22.-, S32.-)
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (10 notes)
- arthropathic psoriasis (L40.5-)
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- compartment syndrome (traumatic) (T79.A-)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Care settings
How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.
Home Health Primary
Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the Musculoskeletal Rehabilitation clinical group.
Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026Hospital CC
Counts as a complication or comorbidity (CC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 214 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.
Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix CNotes
Also from chapter/block level (1 note)
- Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
Alphabetic Index terms
Terms the official Alphabetic Index lists for M48.55. This code adds the 7th character. 2 entries