2027 ICD-10-CM Diagnosis Code M97.21XSPeriprosthetic fracture around internal prosthetic right ankle joint, sequela
M97.21XS is a billable ICD-10-CM diagnosis code for periprosthetic fracture around internal prosthetic right ankle joint, sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 922 through 923. 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 Injury, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
M97.21XS is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Periprosthetic fracture around internal prosthetic joint (M97).
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
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to M97.21XS: its own notes plus those printed at M97 and 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.
- 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.
- 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
- Ainitial encounter
- Dsubsequent encounter
- Ssequela this code
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name M97.21XS, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming M97.21XS: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 2
These codes carry an Excludes2 note naming M97.21XS: 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 classifiedperiprosthetic fracture around internal prosthetic joint (M97.-) names M97.-, which includes this code
- S82 Fracture of lower leg, including ankleperiprosthetic fracture around internal prosthetic ankle joint (M97.2) names M97.2, which includes this code
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 M97.21XS to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code History & ChangesHistory
Replacement M97.21XS replaces the following previously assigned code(s):
- T84.048S - Periprosth fx around oth internal prosth joint, sequela
Questions About M97.21XSOverview
Is M97.21XS a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report periprosthetic fracture around internal prosthetic right ankle joint, sequela on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character S in M97.21XS mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the periprosthetic fracture around internal prosthetic right ankle joint itself has resolved, not the original event.
What MS-DRG does M97.21XS group to?
When periprosthetic fracture around internal prosthetic right ankle joint, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 923, 922, with relative weights from 0.9980 to 1.6248 depending on complications. Higher weights mean higher Medicare reimbursement.
Is M97.21XS 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, sequela on inpatient claims. The code appears in the Periprosthetic fracture around internal prosthetic joint (M97) range of the CMS exempt list.
What is coded first with M97.21XS?
The Code First note at M97, which applies to M97.21XS, reads: if known, the specific type and cause of fracture, such as traumatic or pathological. When one of these applies, it is sequenced before M97.21XS.
