M97.11 — Periprosthetic fracture around internal prosthetic right knee joint
Is M97.11 billable?
No — M97.11 is a non-billable header code. M97.11 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 3 billable codes beneath M97.11.
Billable codes under this header
M97.11 at a glance
| Code | M97.11 |
|---|---|
| Description | Periprosthetic fracture around internal prosthetic right knee joint |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
How is M97.11 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under M97.1, the nearest indexed parent of M97.11. Use them to find the family, then select the specific code.
- Fracture, pathological › periprosthetic › knee (pathologic)
Code first — inherited from M97
The underlying condition below must be sequenced before M97.11. M97.11 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 M97.11, but a patient may have both at the same time. When documentation supports it, M97.11 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 M97.11, but a patient may have both at the same time. When documentation supports it, M97.11 and the excluded code may both be reported.
What codes fall under M97.11? (3)
How long has M97.11 existed?
M97.11 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.