2026 ICD-10-CM Diagnosis Code M97.41XSPeriprosthetic fracture around internal prosthetic right elbow joint, sequela
M97.41XS is a billable ICD-10-CM diagnosis code for periprosthetic fracture around internal prosthetic right elbow 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 2026 (October 1, 2025 through September 30, 2026) 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 elbow prosthesis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
M97.41XS 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 elbow prosthesis
- Fracture of bone adjacent to right elbow 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 M97.41XS to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code History & ChangesHistory
Replacement M97.41XS replaces the following previously assigned code(s):
- T84.048S - Periprosth fx around oth internal prosth joint, sequela
Questions About M97.41XSOverview
Is M97.41XS a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report periprosthetic fracture around internal prosthetic right elbow joint, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in M97.41XS 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 elbow joint itself has resolved, not the original event.
What MS-DRG does M97.41XS group to?
When periprosthetic fracture around internal prosthetic right elbow joint, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 922, 923, with relative weights from 1.0177 to 1.7494 depending on complications. Higher weights mean higher Medicare reimbursement.
Is M97.41XS 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 elbow joint, sequela on inpatient claims.
What is the ICD-9 equivalent of M97.41XS?
Under the General Equivalence Mappings, periprosthetic fracture around internal prosthetic right elbow joint, sequela converts to ICD-9-CM 909.3 (late eff surg/med compl). The mapping is approximate, so confirm the match fits the documentation.
