Collapsed vertebra, NEC, site unsp, sequela of fracture

This code signifies a vertebral collapse that is a long-term consequence of a previous fracture, where the specific location of the affected vertebra is not documented. It indicates a chronic or residual condition resulting from a past traumatic event to the spine, not due to other specified causes like osteoporosis or tumor.

Apply this code when documentation clearly states a collapsed vertebra as a sequela of a prior fracture, and the specific vertebral level (e.g., cervical, thoracic, lumbar) is not identified. This is appropriate for follow-up encounters where the acute fracture has healed, but the vertebral collapse persists as a chronic issue.

• Ensure documentation explicitly links the vertebral collapse to a previous fracture and not an acute event.
• Avoid using this code if a more specific site (e.g., cervical, thoracic, lumbar) is documented; instead, use the appropriate M48.5x- code with the specific site.
• This code should be used as a secondary diagnosis when the primary reason for the encounter is related to the sequela of the collapsed vertebra.