2021 ICD-10-CM Diagnosis Code M97

Periprosthetic fracture around internal prosthetic joint

    2017 - New Code 2018 2019 2020 2021 Non-Billable/Non-Specific Code
  • M97 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
  • The 2021 edition of ICD-10-CM M97 became effective on October 1, 2020.
  • This is the American ICD-10-CM version of M97 - other international versions of ICD-10 M97 may differ.
Type 2 Excludes
Type 2 Excludes Help
A type 2 excludes note represents "not included here". A type 2 excludes note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When a type 2 excludes note appears under a code it is acceptable to use both the code (M97) and the excluded code together.
  • fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate (
    ICD-10-CM Diagnosis Code M96.6

    Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate

      2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
    Applicable To
    • Intraoperative fracture of bone during insertion of orthopedic implant, joint prosthesis, or bone plate
    Type 2 Excludes
    • complication of internal orthopedic devices, implants or grafts (T84.-)
    M96.6-
    )
  • breakage (fracture) of prosthetic joint (
    ICD-10-CM Diagnosis Code T84.01

    Broken internal joint prosthesis

      2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
    Applicable To
    • Breakage (fracture) of prosthetic joint
    • Broken prosthetic joint implant
    Type 1 Excludes
    • periprosthetic joint implant fracture (M97.-)
    T84.01-
    )
The following code(s) above M97 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to M97:
  • M00-M99
    2021 ICD-10-CM Range M00-M99

    Diseases of the musculoskeletal system and connective tissue

    Note
    • Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
    Type 2 Excludes
    • 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)
    Diseases of the musculoskeletal system and connective tissue
Code History
  • 2017 (effective 10/1/2016): New code
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
  • 2021 (effective 10/1/2020): No change
Code annotations containing back-references to M97:
  • Type 1 Excludes: T84.01
    ICD-10-CM Diagnosis Code T84.01

    Broken internal joint prosthesis

      2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
    Applicable To
    • Breakage (fracture) of prosthetic joint
    • Broken prosthetic joint implant
    Type 1 Excludes
    • periprosthetic joint implant fracture (M97.-)
  • Type 2 Excludes: M96
    ICD-10-CM Diagnosis Code M96

    Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified

      2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
    Type 2 Excludes
    • arthropathy following intestinal bypass (M02.0-)
    • complications of internal orthopedic prosthetic devices, implants and grafts (T84.-)
    • disorders associated with osteoporosis (M80)
    • periprosthetic fracture around internal prosthetic joint (M97.-)
    • presence of functional implants and other devices (Z96-Z97)
ICD-10-CM Codes Adjacent To M97
M96.821 Accidental puncture and laceration of a musculoskeletal structure during other procedure
M96.83 Postprocedural hemorrhage of a musculoskeletal structure following a procedure
M96.830 Postprocedural hemorrhage of a musculoskeletal structure following a musculoskeletal system procedure
M96.831 Postprocedural hemorrhage of a musculoskeletal structure following other procedure
M96.84 Postprocedural hematoma and seroma of a musculoskeletal structure following a procedure
M96.840 Postprocedural hematoma of a musculoskeletal structure following a musculoskeletal system procedure
M96.841 Postprocedural hematoma of a musculoskeletal structure following other procedure
M96.842 Postprocedural seroma of a musculoskeletal structure following a musculoskeletal system procedure
M96.843 Postprocedural seroma of a musculoskeletal structure following other procedure
M96.89 Other intraoperative and postprocedural complications and disorders of the musculoskeletal system
M97 Periprosthetic fracture around internal prosthetic joint
M97.0 Periprosthetic fracture around internal prosthetic hip joint
M97.01 Periprosthetic fracture around internal prosthetic right hip joint
M97.01XA …… initial encounter
M97.01XD …… subsequent encounter
M97.01XS …… sequela
M97.02 Periprosthetic fracture around internal prosthetic left hip joint
M97.02XA …… initial encounter
M97.02XD …… subsequent encounter
M97.02XS …… sequela
M97.1 Periprosthetic fracture around internal prosthetic knee joint

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.