2026 ICD-10-CM Diagnosis Code M96.629Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified arm

ICD-10-CM Codes›M00–M99›M96›M96

ICD-10-CM M96.629
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

M96.629 is a billable ICD-10-CM diagnosis code for fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified arm. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 559 through 561. The code is flagged as an unspecified code, since codes identifying laterality exist in the same family. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Postprocedural or postoperative musculoskeletal system complication.

Code Identity

ICD-10-CM Code
M96.629
Billable Status
Yes — Valid for Submission
Code Describes
Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified arm
Short Description
Fx humerus fol insrt ortho implnt/prosth/bone plt, unsp arm
Parent Code
M96.62
Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM96Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified
CategoryM96Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified
This CodeM96.629Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified arm

Code EditsBilling

Medicare Code Editor checks that affect claim validity for M96.629.

Unspecified codes
Unspecified codes exist in the ICD-10-CM classification for circumstances when documentation in the medical record does not provide the level of detail needed to support reporting a more specific code. However, in the inpatient setting, there should generally be very limited and rare circumstances for which the laterality (right, left, bilateral) of a condition is unable to be documented and reported. The following pages contain the list of unspecified ICD-10-CM diagnosis codes for which there is a more specific code to identify laterality (right, left, bilateral) within that code family.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MUS037
Postprocedural or postoperative musculoskeletal system complication
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Fractures

A fracture is a break in a bone. Fractures are usually caused by injuries. Since they can sometimes be serious, it's important to get medical care right away if you think you have a fracture.

The full article covers:

  • What is a fracture?
  • What are the different types of fractures?
  • What causes fractures?
  • What are the symptoms of a fracture?
  • How are fractures diagnosed?
  • What are the treatments for fractures?
  • Can fractures be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert M96.629 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
996.49 Mech com orth dev NEC
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About M96.629Overview

Is M96.629 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified arm on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does M96.629 group to?

When fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified arm is the principal diagnosis on an inpatient stay, it groups to MS-DRG 559, 560, 561, with relative weights from 0.8039 to 1.8649 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of M96.629?

Under the General Equivalence Mappings, fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified arm converts to ICD-9-CM 996.49 (mech com orth dev NEC). The mapping is approximate, so confirm the match fits the documentation.