ICDcodes.org
FY2027

M96.65 — Fracture of pelvis following insertion of orthopedic implant, joint prosthesis, or bone plate

BillableCC

Is M96.65 billable?

Yes — M96.65 is billable for FY2027. M96.65 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. M96.65 may be submitted for encounters from October 1, 2026 through September 30, 2027.

M96.65 at a glance

CodeM96.65
DescriptionFracture of pelvis following insertion of orthopedic implant, joint prosthesis, or bone plate
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

Which MS-DRGs does M96.65 group to?

M96.65 sits in MDC 08 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 559Aftercare, Musculoskeletal System and Connective Tissue with MCCmedical
  • 560Aftercare, Musculoskeletal System and Connective Tissue with CCmedical
  • 561Aftercare, Musculoskeletal System and Connective Tissue without CC/MCCmedical

As a secondary diagnosis, M96.65 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is M96.65 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to M96.65. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Fracture, traumatic › following insertionof orthopedic implant, joint prosthesis or bone plate › pelvis (abduction) (adduction) (separation)
  • Fracture, traumatic › pelvis, pelvic › following insertion of implant, prosthesis or plate (abduction) (adduction) (separation)

Excludes2 — not included here — inherited from Chapter 13

The conditions below are not part of M96.65, but a patient may have both at the same time. When documentation supports it, M96.65 and the excluded code may both be reported.

  • 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)

Excludes2 — not included here — inherited from M96

The conditions below are not part of M96.65, but a patient may have both at the same time. When documentation supports it, M96.65 and the excluded code may both be reported.

  • 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)

Excludes2 — not included here — inherited from M96.6

The conditions below are not part of M96.65, but a patient may have both at the same time. When documentation supports it, M96.65 and the excluded code may both be reported.

  • complication of internal orthopedic devices, implants or grafts (T84.-)

How long has M96.65 existed?

M96.65 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

What other codes are in the M96.6 family? (5)