M97.02XA — Periprosthetic fracture around internal prosthetic left hip joint, initial encounter
Is M97.02XA billable?
Yes — M97.02XA is billable for FY2027. M97.02XA is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. M97.02XA may be submitted for encounters from October 1, 2026 through September 30, 2027.
M97.02XA at a glance
| Code | M97.02XA |
|---|---|
| Description | Periprosthetic fracture around internal prosthetic left hip joint, initial encounter |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter |
What does the 7th character "A" mean in M97.02XA?
In M97.02XA, the 7th character A means initial encounter. The 7th character is required for M97.02XA to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does M97.02XA group to?
M97.02XA 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, M97.02XA is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is M97.02XA listed in the Alphabetic Index?
The Alphabetic Index lists these routes under M97.0, the nearest indexed parent of M97.02XA. Use them to find the family, then select the specific code.
- Fracture, pathological › periprosthetic › hip (pathologic)
- Fracture, traumatic › periprosthetic, around internal prosthetic joint › hip (abduction) (adduction) (separation)
Code first — inherited from M97
The underlying condition below must be sequenced before M97.02XA. M97.02XA 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 — inherited from Chapter 13
The conditions below are not part of M97.02XA, but a patient may have both at the same time. When documentation supports it, M97.02XA 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 M97
The conditions below are not part of M97.02XA, but a patient may have both at the same time. When documentation supports it, M97.02XA and the excluded code may both be reported.
How long has M97.02XA existed?
M97.02XA 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.