2026 ICD-10-CM Diagnosis Code M97Periprosthetic fracture around internal prosthetic joint
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
Code Classification
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
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Code First
- , if known, the specific type and cause of fracture, such as traumatic or pathological
Type 2 Excludes
- 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
- The appropriate 7th character is to be added to each code from category M97
7th Character
- A - initial encounter
- D - subsequent encounter
- S - sequela
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.
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.
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.
Indicates that a seventh character is to be assigned to codes in a subcategory.
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
Questions About M97Overview
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.
