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ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 M48.11

Billable / Specific

Ankylosing hyperostosis [Forestier], occipito-atlanto-axial region

M48
Block
0
Synonyms
442
LCDs
14
Payer Policies
0
Linked CPTs

About ICD-10-CM M48.11

ICD-10-CM code M48.11 represents Ankylosing hyperostosis [Forestier], occipito-atlanto-axial region. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M48). The 2026 edition of ICD-10-CM M48.11 became effective on October 1, 2025.

Medicare LCD Coverage for M48.11

Local Coverage Determinations (LCDs) from CMS MACs that list M48.11 as a covered diagnosis.

442 LCDs

Showing top 10 of 442 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98942 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98940 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98941 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98943 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95909 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95887 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95912 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95999 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95910 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95870 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M48.11.

14 policies

1 Cigna

Intraoperative Monitoring - (0509)
Policy ID: MM_0509

5 Medicare

Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: Nerve Conduction Studies and Electromyography
Policy ID: ART-54969
Billing and Coding: Chiropractic Services
Policy ID: ART-56273

CPT Codes Commonly Billed with M48.11

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for M48.11

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert M48.11 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
M48.11 7216 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To M48.11

Other codes in section M45-M49 (Spondylopathies).

M45 Ankylosing spondylitis (non-billable) M45.0 Ankylosing spondylitis of multiple sites in spine M45.1 Ankylosing spondylitis of occipito-atlanto-axial region M45.2 Ankylosing spondylitis of cervical region M45.3 Ankylosing spondylitis of cervicothoracic region M45.4 Ankylosing spondylitis of thoracic region M45.5 Ankylosing spondylitis of thoracolumbar region M45.6 Ankylosing spondylitis lumbar region M45.7 Ankylosing spondylitis of lumbosacral region M45.8 Ankylosing spondylitis sacral and sacrococcygeal region M45.9 Ankylosing spondylitis of unspecified sites in spine M45.A Non-radiographic axial spondyloarthritis (non-billable) M45.A0 Non-radiographic axial spondyloarthritis of unspecified sites in spine M45.A1 Non-radiographic axial spondyloarthritis of occipito-atlanto-axial region M45.A2 Non-radiographic axial spondyloarthritis of cervical region M45.A3 Non-radiographic axial spondyloarthritis of cervicothoracic region M45.A4 Non-radiographic axial spondyloarthritis of thoracic region M45.A5 Non-radiographic axial spondyloarthritis of thoracolumbar region M45.A6 Non-radiographic axial spondyloarthritis of lumbar region M45.A7 Non-radiographic axial spondyloarthritis of lumbosacral region

ICD-10 M48.11, Billing FAQ

Is ICD-10 code M48.11 billable? +

Yes, M48.11 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What ICD-9 codes does M48.11 map to? +

Per CMS GEMs, M48.11 maps to ICD-9 codes: 7216. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on July 16, 2026.

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