All ICD10 Codes

M97

Non-Billable
ChapterM00–M99
Rankcategory
Official Description

Periprosthetic fracture around internal prosthetic joint

Use a more specific code (2 billable, 5 non-billable)
M97.0Periprosthetic fracture around internal prosthetic hip jointhas subcodesM97.1Periprosthetic fracture around internal prosthetic knee jointhas subcodesM97.2Periprosthetic fracture around internal prosthetic ankle jointhas subcodesM97.3Periprosthetic fracture around internal prosthetic shoulder jointhas subcodesM97.4Periprosthetic fracture around internal prosthetic elbow jointhas subcodesM97.8Periprosthetic fracture around other internal prosthetic jointM97.9Periprosthetic fracture around unspecified internal prosthetic joint
Metadata & Insights
  • •Non-billable category (requires more specific sub-code).
  • •Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99).

CH13 Parent Instructions

Excludes2(Not included here. Code separately if applicable.)
  • 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)

Instructional Notes

Excludes2(Not included here. Code separately if applicable.)
  • fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate (M96.6-)
  • breakage (fracture) of prosthetic joint (T84.01-)
Code First
  • , if known, the specific type and cause of fracture, such as traumatic or pathological

Clinical Hierarchy

BillableHas subcodes
CH13Diseases of the musculoskeletal system and connective tissue (M00-M99)
M97Periprosthetic fracture around internal prosthetic jointNot billable
M97.0Periprosthetic fracture around internal prosthetic hip jointSubcodes
M97.1Periprosthetic fracture around internal prosthetic knee jointSubcodes
M97.2Periprosthetic fracture around internal prosthetic ankle jointSubcodes
M97.3Periprosthetic fracture around internal prosthetic shoulder jointSubcodes
M97.4Periprosthetic fracture around internal prosthetic elbow jointSubcodes
M97.8Periprosthetic fracture around other internal prosthetic jointBillable
M97.9Periprosthetic fracture around unspecified internal prosthetic jointBillable

Applicable Ancestor Context

The following parent sections contain instructions or notes that apply to M97:

chapterCH13
Diseases of the musculoskeletal system and connective tissue (M00-M99)
View context instructions

MS-DRG Classification

2026

No direct MS-DRG triggers identified.

Cross Reference

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