2024 ICD-10-CM Diagnosis Code M97.9XXA

Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter

ICD-10-CM Code:
M97.9XXA
ICD-10 Code for:
Periprosth fracture around unsp internal prosth joint, init
Is Billable?
Yes - Valid for Submission
Code Navigator:

Code Classification

  • Diseases of the musculoskeletal system and connective tissue
    (M00–M99)
    • Periprosthetic fracture around internal prosthetic joint
      (M97)
      • Periprosthetic fracture around internal prosthetic joint
        (M97)

M97.9XXA is a billable diagnosis code used to specify a medical diagnosis of periprosthetic fracture around unspecified internal prosthetic joint, initial encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

M97.9XXA is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like periprosthetic fracture around unspecified internal prosthetic joint. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.

Unspecified diagnosis codes like M97.9XXA are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Clinical Classification

Replacement Code

M979XXA replaces the following previously assigned ICD-10-CM code(s):

  • T84.049A - Periprosth fracture around unsp internal prosth joint, init

Convert M97.9XXA to ICD-9-CM

  • ICD-9-CM Code: 996.44 - Periprosthetc fx-pros jt
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education


Fractures

A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the bone.

Symptoms of a fracture are:

  • Intense pain
  • Deformity - the limb looks out of place
  • Swelling, bruising, or tenderness around the injury
  • Numbness and tingling
  • Problems moving a limb

You need to get medical care right away for any fracture. An x-ray can tell if your bone is broken. You may need to wear a cast or splint. Sometimes you need surgery to put in plates, pins or screws to keep the bone in place.


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018