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  6. 2025 ICD-10-CM Code M97

2025 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:

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 2025 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

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

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

What is a fracture?

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.

What are the different types of fractures?

There are different ways to describe fractures. For example, there are different types of fractures based on:

  • Whether the bone is partially or completely broken.
  • Whether the bone breaks through the skin; if it does, it's called an open (or compound) fracture. If not, it's a closed fracture.
  • The direction or shape of the break, for example if it's in a line across the bone or if it has some kind of pattern.
  • The cause of the break. For example, a stress fracture is a small break in a bone that is often caused by overuse.
  • Which bone is broken, for example facial fractures include nose and jaw fractures.

What causes fractures?

Fractures commonly happen because of car accidents, falls, or sports injuries. Overuse and repetitive motions can also cause fractures.

Low bone density and osteoporosis are conditions which cause weakening of your bones. Having one of these conditions makes you much more likely to break a bone.

What are the symptoms of a fracture?

The symptoms of a fracture can vary, depending on which bone you broke. But they may include:

  • Intense pain
  • Deformity, for example a limb that looks out of place
  • Swelling, bruising, or tenderness around the injury
  • Trouble moving the injured part

If you think that you may have broken a bone, get medical care right away.

How are fractures diagnosed?

To find out if you have a fracture, your health provider will do a physical exam and ask about your injury. They will also likely order an x-ray or other imaging test to see if your bone is broken.

What are the treatments for fractures?

The most common treatment for a fracture is for you to wear a cast or a splint. This will keep your bone from moving while it heals. How long you need to wear it will depend on the type of fracture and which bone is affected. But it's often for several weeks. Your provider will let you when you can get it off.

In some cases, you may need surgery to put in plates, pins, or screws to keep the bone in place.

Can fractures be prevented?

There are steps you can take to lower your risk of fractures:

  • Keeping your bones strong by:
    • Getting enough calcium and vitamin D in your diet
    • Getting regular physical activity, including weight bearing exercises such as walking, tennis, and dancing
    • Getting treatment for low bone density or osteoporosis (if needed)
  • Wearing protective equipment when you do sports
  • Preventing falls by:
    • Getting rid of any tripping hazards in your home
    • Being careful when walking on wet or icy surfaces
    • Choosing the right footwear

[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