2027 ICD-10-CM Diagnosis Code M97Periprosthetic fracture around internal prosthetic joint

ICD-10-CM Codes›M00–M99›M97›M97

ICD-10-CM M97
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

M97 is a non-billable ICD-10-CM category code for periprosthetic fracture around internal prosthetic joint, so it cannot be submitted on claims. Use a more specific code from this category instead, such as M97.01XA, M97.01XD, M97.01XS, and M97.02XA.

Code Identity

ICD-10-CM Code
M97
Billable Status
No — Non-Billable Category
Code Describes
Periprosthetic fracture around internal prosthetic joint
Short Description
Periprosthetic fracture around internal prosthetic joint
Same as the full description in the CMS dataset.
Chapter
M97
Periprosthetic fracture around internal prosthetic joint

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM97Periprosthetic fracture around internal prosthetic joint
CategoryM97Periprosthetic fracture around internal prosthetic joint
This CodeM97Periprosthetic fracture around internal prosthetic joint

Specific Coding for Periprosthetic fracture around internal prosthetic jointOverview

Non-specific codes like M97 require more characters. Use one of these billable codes instead:

  • M97.0 for Periprosthetic fracture around internal prosthetic hip joint

  • M97.01 for Periprosthetic fracture around internal prosthetic right hip joint

  • M97.02 for Periprosthetic fracture around internal prosthetic left hip joint

  • M97.1 for Periprosthetic fracture around internal prosthetic knee joint

  • M97.11 for Periprosthetic fracture around internal prosthetic right knee joint

  • M97.12 for Periprosthetic fracture around internal prosthetic left knee joint

  • M97.2 for Periprosthetic fracture around internal prosthetic ankle joint

  • M97.21 for Periprosthetic fracture around internal prosthetic right ankle joint

  • M97.22 for Periprosthetic fracture around internal prosthetic left ankle joint

  • M97.3 for Periprosthetic fracture around internal prosthetic shoulder joint

  • M97.31 for Periprosthetic fracture around internal prosthetic right shoulder joint

  • M97.32 for Periprosthetic fracture around internal prosthetic left shoulder joint

  • M97.4 for Periprosthetic fracture around internal prosthetic elbow joint

  • M97.41 for Periprosthetic fracture around internal prosthetic right elbow joint

  • M97.42 for Periprosthetic fracture around internal prosthetic left elbow joint

  • M97.8 for Periprosthetic fracture around other internal prosthetic joint

  • M97.9 for Periprosthetic fracture around unspecified internal prosthetic joint

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to M97: its own notes plus those printed at Chapter 13. A note printed at a category, block or chapter applies to every code under it.

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

On M97 itself
  • fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate (M96.6-)
  • breakage (fracture) of prosthetic joint (T84.01-)
From Chapter 13 (M00-M99) Diseases of the musculoskeletal system and connective tissue applies to 6,687 codes
  • 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)

Code First

The underlying condition named in the note is sequenced before this code.

  • if known, the specific type and cause of fracture, such as traumatic or pathological

Notes

General instructions on how these codes are used.

From Chapter 13 (M00-M99) Diseases of the musculoskeletal system and connective tissue applies to 6,687 codes
  • Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition

7th Character

Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.

  • The appropriate 7th character is to be added to each code from category M97
Values for category M97 Encounter: Initial, Subsequent, Sequela
  • Ainitial encounter
  • Dsubsequent encounter
  • Ssequela

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name M97, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming M97: they are not reported together with it, unless the two conditions are unrelated.

  • T84.01 Broken internal joint prosthesis
    periprosthetic joint implant fracture (M97.-)

Excludes2 1

These codes carry an Excludes2 note naming M97: its condition is not part of those codes, and both may be reported when the patient has both.

  • M96 Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified
    periprosthetic fracture around internal prosthetic joint (M97.-)

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.

Code HistoryHistory

FY 2019AddedAdded to the ICD-10-CM code setEffective October 1, 2018.
FY 2020–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About M97Overview

What is the ICD-10 code for periprosthetic fracture around internal prosthetic joint?

M97 is the ICD-10-CM category for periprosthetic fracture around internal prosthetic joint, but it is a non-billable header: claims need a more specific code from this category, listed on this page.

Is M97 (Periprosthetic fracture around internal prosthetic joint) a billable code?

No. This is a category header that groups the codes for periprosthetic fracture around internal prosthetic joint, and headers cannot be submitted on claims. Claims for periprosthetic fracture around internal prosthetic joint need a more specific code from this category, such as M97.01XA, M97.01XD, and M97.01XS.

What is coded first with M97?

The Code First note reads: if known, the specific type and cause of fracture, such as traumatic or pathological. When one of these applies, it is sequenced before M97.