2019/2020

  1. ICD-10-CM Codes
    2. ›
  2. M00-M99 Diseases of the musculoskeletal system and connective tissue
    3. ›
  3. M97-M97 Periprosthetic fracture around internal prosthetic joint
    4. ›
  4. M97- Periprosthetic fracture around internal prosthetic joint
    5. ›

2020 ICD-10-CM Diagnosis Code M97.0

Periprosthetic fracture around internal prosthetic hip joint

    2017 - New Code 2018 2019 2020 Non-Billable/Non-Specific Code
  • M97.0 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
  • The 2020 edition of ICD-10-CM M97.0 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of M97.0 - other international versions of ICD-10 M97.0 may differ.
The following code(s) above M97.0 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 M97.0:
  • M00-M99
    2020 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
  • M97
    ICD-10-CM Diagnosis Code M97

    Periprosthetic fracture around internal prosthetic joint

      2017 - New Code 2018 2019 2020 Non-Billable/Non-Specific Code
    Type 2 Excludes
    • fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate (M96.6-)
    • breakage (fracture) of prosthetic joint (T84.01-)
    Periprosthetic fracture around internal prosthetic joint
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
Code annotations containing back-references to M97.0:
  • Type 2 Excludes: S82
    , S72
    ICD-10-CM Diagnosis Code S82

    Fracture of lower leg, including ankle

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Includes
    • fracture of malleolus
    Note
    • A fracture not indicated as displaced or nondisplaced should be coded to displaced
    • A fracture not indicated as open or closed should be coded to closed
    • The open fracture designations are based on the Gustilo open fracture classification
    Type 1 Excludes
    • traumatic amputation of lower leg (S88.-)
    Type 2 Excludes
    • fracture of foot, except ankle (S92.-)
    • periprosthetic fracture of prosthetic implant of knee (M97.0-)
    ICD-10-CM Diagnosis Code S72

    Fracture of femur

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Note
    • A fracture not indicated as displaced or nondisplaced should be coded to displaced
    • A fracture not indicated as open or closed should be coded to closed
    • The open fracture designations are based on the Gustilo open fracture classification
    Type 1 Excludes
    • traumatic amputation of hip and thigh (S78.-)
    Type 2 Excludes
    • fracture of lower leg and ankle (S82.-)
    • fracture of foot (S92.-)
    • periprosthetic fracture of prosthetic implant of hip (M97.0-)

Diagnosis Index entries containing back-references to M97.0:
  • Fracture, pathological (pathologic) - see also Fracture, traumatic M84.40
    • periprosthetic M97.9
      ICD-10-CM Diagnosis Code M97.9

      Periprosthetic fracture around unspecified internal prosthetic joint

        2017 - New Code 2018 2019 2020 Non-Billable/Non-Specific Code
      • hip M97.0-
  • Fracture, traumatic (abduction) (adduction) (separation) T14.8
    - see also Fracture, pathological
    ICD-10-CM Diagnosis Code T14.8

    Other injury of unspecified body region

      2016 2017 2018 - Converted to Parent Code 2019 2020 Non-Billable/Non-Specific Code
    Applicable To
    • Abrasion NOS
    • Contusion NOS
    • Crush injury NOS
    • Fracture NOS
    • Skin injury NOS
    • Vascular injury NOS
    • Wound NOS

ICD-10-CM Codes Adjacent To M97.0
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
M97.11 Periprosthetic fracture around internal prosthetic right knee joint

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

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