Version 2024

2024 ICD-10-CM Diagnosis Code M97

Periprosthetic fracture around internal prosthetic joint

ICD-10-CM Code:
M97
ICD-10 Code for:
Periprosthetic fracture around internal prosthetic joint
Is Billable?
Not 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 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of periprosthetic fracture around internal prosthetic joint. The code is not specific and is NOT valid for the year 2024 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Specific Coding Applicable to Periprosthetic fracture around internal prosthetic joint

Non-specific codes like M97 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for periprosthetic fracture around internal prosthetic joint:

  • M97.0 for Periprosthetic fracture around internal prosthetic hip joint - NON-BILLABLE CODE

  • M97.01 for Periprosthetic fracture around internal prosthetic right hip joint - NON-BILLABLE CODE

  • M97.02 for Periprosthetic fracture around internal prosthetic left hip joint - NON-BILLABLE CODE

  • M97.1 for Periprosthetic fracture around internal prosthetic knee joint - NON-BILLABLE CODE

  • M97.11 for Periprosthetic fracture around internal prosthetic right knee joint - NON-BILLABLE CODE

  • M97.12 for Periprosthetic fracture around internal prosthetic left knee joint - NON-BILLABLE CODE

  • M97.2 for Periprosthetic fracture around internal prosthetic ankle joint - NON-BILLABLE CODE

  • M97.21 for Periprosthetic fracture around internal prosthetic right ankle joint - NON-BILLABLE CODE

  • M97.22 for Periprosthetic fracture around internal prosthetic left ankle joint - NON-BILLABLE CODE

  • M97.3 for Periprosthetic fracture around internal prosthetic shoulder joint - NON-BILLABLE CODE

  • M97.31 for Periprosthetic fracture around internal prosthetic right shoulder joint - NON-BILLABLE CODE

  • M97.32 for Periprosthetic fracture around internal prosthetic left shoulder joint - NON-BILLABLE CODE

  • M97.4 for Periprosthetic fracture around internal prosthetic elbow joint - NON-BILLABLE CODE

  • M97.41 for Periprosthetic fracture around internal prosthetic right elbow joint - NON-BILLABLE CODE

  • M97.42 for Periprosthetic fracture around internal prosthetic left elbow joint - NON-BILLABLE CODE

  • M97.8 for Periprosthetic fracture around other internal prosthetic joint - NON-BILLABLE CODE

  • M97.9 for Periprosthetic fracture around unspecified internal prosthetic joint - NON-BILLABLE CODE

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


Code First

Code First
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
  • , if known, the specific type and cause of fracture, such as traumatic or pathological

Type 2 Excludes

Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
  • fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate M96.6
  • breakage fracture of prosthetic joint T84.01

7th Character Note

7th Character Note
Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
  • The appropriate 7th character is to be added to each code from category M97

7th Character

7th Character
Indicates that a seventh character is to be assigned to codes in a subcategory.
  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

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