M97 — Periprosthetic fracture around internal prosthetic joint
Not billable
Is M97 billable?
No — M97 is a non-billable header code. M97 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 36 billable codes beneath M97.
Billable codes under this header
- M97.8XXAPeriprosthetic fracture around other internal prosthetic joint, initial encounter
- M97.8XXDPeriprosthetic fracture around other internal prosthetic joint, subsequent encounter
- M97.8XXSPeriprosthetic fracture around other internal prosthetic joint, sequela
- M97.9XXAPeriprosthetic fracture around unspecified internal prosthetic joint, initial encounter
- M97.9XXDPeriprosthetic fracture around unspecified internal prosthetic joint, subsequent encounter
- M97.9XXSPeriprosthetic fracture around unspecified internal prosthetic joint, sequela
- M97.01XAPeriprosthetic fracture around internal prosthetic right hip joint, initial encounter
- M97.01XDPeriprosthetic fracture around internal prosthetic right hip joint, subsequent encounter
- M97.01XSPeriprosthetic fracture around internal prosthetic right hip joint, sequela
- M97.02XAPeriprosthetic fracture around internal prosthetic left hip joint, initial encounter
- M97.02XDPeriprosthetic fracture around internal prosthetic left hip joint, subsequent encounter
- M97.02XSPeriprosthetic fracture around internal prosthetic left hip joint, sequela
- M97.11XAPeriprosthetic fracture around internal prosthetic right knee joint, initial encounter
- M97.11XDPeriprosthetic fracture around internal prosthetic right knee joint, subsequent encounter
- M97.11XSPeriprosthetic fracture around internal prosthetic right knee joint, sequela
- M97.12XAPeriprosthetic fracture around internal prosthetic left knee joint, initial encounter
- M97.12XDPeriprosthetic fracture around internal prosthetic left knee joint, subsequent encounter
- M97.12XSPeriprosthetic fracture around internal prosthetic left knee joint, sequela
- M97.21XAPeriprosthetic fracture around internal prosthetic right ankle joint, initial encounter
- M97.21XDPeriprosthetic fracture around internal prosthetic right ankle joint, subsequent encounter
- M97.21XSPeriprosthetic fracture around internal prosthetic right ankle joint, sequela
- M97.22XAPeriprosthetic fracture around internal prosthetic left ankle joint, initial encounter
- M97.22XDPeriprosthetic fracture around internal prosthetic left ankle joint, subsequent encounter
- M97.22XSPeriprosthetic fracture around internal prosthetic left ankle joint, sequela
- M97.31XAPeriprosthetic fracture around internal prosthetic right shoulder joint, initial encounter
- M97.31XDPeriprosthetic fracture around internal prosthetic right shoulder joint, subsequent encounter
- M97.31XSPeriprosthetic fracture around internal prosthetic right shoulder joint, sequela
- M97.32XAPeriprosthetic fracture around internal prosthetic left shoulder joint, initial encounter
- M97.32XDPeriprosthetic fracture around internal prosthetic left shoulder joint, subsequent encounter
- M97.32XSPeriprosthetic fracture around internal prosthetic left shoulder joint, sequela
- M97.41XAPeriprosthetic fracture around internal prosthetic right elbow joint, initial encounter
- M97.41XDPeriprosthetic fracture around internal prosthetic right elbow joint, subsequent encounter
- M97.41XSPeriprosthetic fracture around internal prosthetic right elbow joint, sequela
- M97.42XAPeriprosthetic fracture around internal prosthetic left elbow joint, initial encounter
- M97.42XDPeriprosthetic fracture around internal prosthetic left elbow joint, subsequent encounter
- M97.42XSPeriprosthetic fracture around internal prosthetic left elbow joint, sequela
M97 at a glance
| Code | M97 |
|---|---|
| Description | Periprosthetic fracture around internal prosthetic joint |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Code first
The underlying condition below must be sequenced before M97. M97 describes a manifestation and cannot be the principal or first-listed diagnosis.
- , if known, the specific type and cause of fracture, such as traumatic or pathological
Excludes2 — not included here
The conditions below are not part of M97, but a patient may have both at the same time. When documentation supports it, M97 and the excluded code may both be reported.
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M97, but a patient may have both at the same time. When documentation supports it, M97 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)
What codes fall under M97? (7)
- M97.0Periprosthetic fracture around internal prosthetic hip jointnot billable
- M97.1Periprosthetic fracture around internal prosthetic knee jointnot billable
- M97.2Periprosthetic fracture around internal prosthetic ankle jointnot billable
- M97.3Periprosthetic fracture around internal prosthetic shoulder jointnot billable
- M97.4Periprosthetic fracture around internal prosthetic elbow jointnot billable
- M97.8Periprosthetic fracture around other internal prosthetic jointnot billable
- M97.9Periprosthetic fracture around unspecified internal prosthetic jointnot billable
How long has M97 existed?
M97 first appears in FY2018 (FY2017 is not available, so it may have appeared then).
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.