M48.58XA: Collapsed vertebra, not elsewhere classified, sacral and sacrococcygeal region, initial encounter for fracture
M48.58XA, collapsed vertebra, not elsewhere classified, sacral and sacrococcygeal region, initial encounter for fracture, is listed as a covered diagnosis in 5 Medicare billing and coding articles that apply to 11 HCPCS Level II codes, including G0130 (Single energy x-ray absorptiometry (sexa) bone density…), G0453 (Continuous intraoperative neurophysiology monitoring, from…), A9585 (Injection, gadobutrol, 0.1 ml). The articles come from 4 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with M48.58XA as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0130 | Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) | Special coverage instructions apply | — | 2 |
| G0453 | Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure) | Carrier judgment | — | 1 |
| A9585 | Injection, gadobutrol, 0.1 ml | Carrier judgment | — | 1 |
| Q9953 | Injection, iron-based magnetic resonance contrast agent, per ml | Special coverage instructions apply | — | 1 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G2010 | Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment | Carrier judgment | — | 1 |
| G2250 | Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment | Carrier judgment | — | 1 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G2251 | Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of clinical discussion | Carrier judgment | — | 1 |
| G0151 | Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 1 |
Medicare policy articles listing M48.58XA
- A59040: Billing and Coding: Bone Mass Measurement (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36460, L39268
- A57132: Billing and Coding: Bone Mass Measurement (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36460, L39268
- A57604: Billing and Coding: Intraoperative Neurophysiological Testing (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34623, L35003
- A57206: Billing and Coding: Lumbar MRI (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L34220
- A57311: Billing and Coding: Physical Therapy - Home Health (CGS Administrators, LLC (HHH MAC); 7 Level II codes). LCD with the same title: L33942
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other M48 diagnoses (Other spondylopathies)
- M48.50XA — Collapsed vertebra, not elsewhere classified, site unspecified…
- M48.51XA — Collapsed vertebra, not elsewhere classified, occipito-atlanto-axial…
- M48.52XA — Collapsed vertebra, not elsewhere classified, cervical region…
- M48.53XA — Collapsed vertebra, not elsewhere classified, cervicothoracic…
- M48.54XA — Collapsed vertebra, not elsewhere classified, thoracic region…
- M48.55XA — Collapsed vertebra, not elsewhere classified, thoracolumbar region…
- M48.56XA — Collapsed vertebra, not elsewhere classified, lumbar region, initial…
- M48.57XA — Collapsed vertebra, not elsewhere classified, lumbosacral region…
- M48.01 — Spinal stenosis, occipito-atlanto-axial region
- M48.02 — Spinal stenosis, cervical region
- M48.03 — Spinal stenosis, cervicothoracic region
- M48.04 — Spinal stenosis, thoracic region
- M48.05 — Spinal stenosis, thoracolumbar region
- M48.061 — Spinal stenosis, lumbar region without neurogenic claudication
- M48.062 — Spinal stenosis, lumbar region with neurogenic claudication
- M48.07 — Spinal stenosis, lumbosacral region
- M48.08 — Spinal stenosis, sacral and sacrococcygeal region
- M48.11 — Ankylosing hyperostosis [Forestier], occipito-atlanto-axial region
- M48.12 — Ankylosing hyperostosis [Forestier], cervical region
- M48.13 — Ankylosing hyperostosis [Forestier], cervicothoracic region
- M48.14 — Ankylosing hyperostosis [Forestier], thoracic region
- M48.15 — Ankylosing hyperostosis [Forestier], thoracolumbar region
- M48.16 — Ankylosing hyperostosis [Forestier], lumbar region
- M48.17 — Ankylosing hyperostosis [Forestier], lumbosacral region
- M48.18 — Ankylosing hyperostosis [Forestier], sacral and sacrococcygeal region
- M48.19 — Ankylosing hyperostosis [Forestier], multiple sites in spine
- M48.21 — Kissing spine, occipito-atlanto-axial region
- M48.22 — Kissing spine, cervical region
- M48.23 — Kissing spine, cervicothoracic region
- M48.24 — Kissing spine, thoracic region
Frequently asked questions
Does Medicare cover M48.58XA (Collapsed vertebra, not elsewhere classified, sacral and…)?
Medicare covers items and services, not diagnoses. 5 Medicare billing and coding articles list M48.58XA as a covered diagnosis for 11 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 M48.58XA?
The Level II codes from the policies most specific to this diagnosis are G0130 (Single energy x-ray absorptiometry (sexa) bone density…, 2 articles); G0453 (Continuous intraoperative neurophysiology monitoring, from…, 1 article); A9585 (Injection, gadobutrol, 0.1 ml, 1 article); Q9953 (Injection, iron-based magnetic resonance contrast agent…, 1 article); G0283 (Electrical stimulation (unattended), to one or more areas…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list M48.58XA?
A59040 (Billing and Coding: Bone Mass Measurement); A57132 (Billing and Coding: Bone Mass Measurement); A57604 (Billing and Coding: Intraoperative Neurophysiological Testing), and 2 more articles.
What is ICD-10-CM code M48.58XA?
M48.58XA is the ICD-10-CM code for collapsed vertebra, not elsewhere classified, sacral and sacrococcygeal region, initial encounter for fracture, in category M48 (Other spondylopathies), chapter 13: Diseases of the musculoskeletal system and connective tissue.
Next steps
- Run a reimbursement report for a device billed under G0130
- Watch G0130 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0130
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 13: Diseases of the musculoskeletal system and connective tissue · All diagnoses · HCPCS lookup