Periprosthetic fracture around internal prosthetic joint (M97) ICD-10-CM

Code First

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.

• , if known, the specific type and cause of fracture, such as traumatic or pathological

Type 2 Excludes

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.

• 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

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.

• The appropriate 7th character is to be added to each code from category M97

7th Character

Indicates that a seventh character is to be assigned to codes in a subcategory.

• A - initial encounter
• D - subsequent encounter
• S - sequela