2026 ICD-10-CM Diagnosis Code M97.9XXSPeriprosthetic fracture around unspecified internal prosthetic joint, sequela

ICD-10-CM Codes›M00–M99›M97›M97

ICD-10-CM M97.9XXS
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

M97.9XXS is a billable ICD-10-CM diagnosis code for periprosthetic fracture around unspecified internal prosthetic 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury, sequela.

Code Identity

ICD-10-CM Code
M97.9XXS
Billable Status
Yes — Valid for Submission
Code Describes
Periprosthetic fracture around unspecified internal prosthetic joint, sequela
Short Description
Periprosth fx around unsp internal prosth joint, sequela
Parent Code
M97.9
Periprosthetic fracture around unspecified internal prosthetic joint

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM97Periprosthetic fracture around internal prosthetic joint
CategoryM97Periprosthetic fracture around internal prosthetic joint
This CodeM97.9XXSPeriprosthetic fracture around unspecified internal prosthetic joint, sequela

Present on Admission (POA)Billing

M97.9XXS is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ073
Injury, sequela
Default principal diagnosis: inpatient Yes · outpatient Yes

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 M97.9XXS to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
909.3 Late eff surg/med compl
Approximate The match is approximate rather than exact.

Code History & ChangesHistory

Replacement M97.9XXS replaces the following previously assigned code(s):

  • T84.049S - Periprosth fx around unsp internal prosth joint, sequela
FY 2018AddedAdded to the ICD-10-CM code setEffective October 1, 2017.
FY 2019–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About M97.9XXSOverview

Is M97.9XXS a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report periprosthetic fracture around unspecified internal prosthetic joint, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character S in M97.9XXS mean?

The final character S makes this a sequela code: it reports a lingering problem that remains after the periprosthetic fracture around unspecified internal prosthetic joint itself has resolved, not the original event.

What MS-DRG does M97.9XXS group to?

When periprosthetic fracture around unspecified internal prosthetic 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 M97.9XXS 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 unspecified internal prosthetic joint, sequela on inpatient claims.

What is the ICD-9 equivalent of M97.9XXS?

Under the General Equivalence Mappings, periprosthetic fracture around unspecified internal prosthetic 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.