2026 ICD-10-CM Diagnosis Code M97.21XDPeriprosthetic fracture around internal prosthetic right ankle joint, subsequent encounter
M97.21XD is a billable ICD-10-CM diagnosis code for periprosthetic fracture around internal prosthetic right ankle joint, subsequent encounter. The 7th character D marks it as a subsequent encounter code, used during routine care in the healing or recovery phase. 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 exempt from POA reporting. Coders also document this condition as fracture of bone adjacent to ankle joint prosthesis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fracture of lower limb (except hip), subsequent encounter.
Code Identity
Code Classification
Present on Admission (POA)Billing
M97.21XD is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Fracture of bone adjacent to ankle joint prosthesis
- Fracture of bone adjacent to right ankle joint prosthesis
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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 M97.21XD to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code History & ChangesHistory
Replacement M97.21XD replaces the following previously assigned code(s):
- T84.048D - Periprosth fracture around oth internal prosth joint, subs
Questions About M97.21XDOverview
Is M97.21XD a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report periprosthetic fracture around internal prosthetic right ankle joint, subsequent encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character D in M97.21XD mean?
The final character D marks a subsequent encounter: use it for routine care while the periprosthetic fracture around internal prosthetic right ankle joint is healing, after active treatment has ended.
What MS-DRG does M97.21XD group to?
When periprosthetic fracture around internal prosthetic right ankle joint, subsequent encounter 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.
Is M97.21XD exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for periprosthetic fracture around internal prosthetic right ankle joint, subsequent encounter on inpatient claims.
What is the ICD-9 equivalent of M97.21XD?
Under the General Equivalence Mappings, periprosthetic fracture around internal prosthetic right ankle joint, subsequent encounter converts to ICD-9-CM V54.26 (aftrcare path fx low leg). The mapping is approximate, so confirm the match fits the documentation.
