M97
Non-Billable

Periprosthetic fracture around internal prosthetic joint

Non-Billable / Non-Specific Code

What is Periprosthetic fracture around internal prosthetic joint?

ICD-10-CM M97 is the diagnosis code for Periprosthetic fracture around internal prosthetic joint. This code falls under the section "Periprosthetic fracture around internal prosthetic joint" within Chapter 13 — Diseases of the musculoskeletal system and connective tissue (M00-M99). It is a non-billable/non-specific ICD-10-CM code that should not be used for reimbursement. A more specific sub-code is required for billing. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.

â„šī¸ Excludes2

Coding Guidelines for M97

â„šī¸ Type 2 Excludes (Code separately if applicable)

The following conditions are not included in M97. If the patient has both, code each condition separately:

  • fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate (M96.6-)
  • breakage (fracture) of prosthetic joint (T84.01-)

ICD-10-CM Code Hierarchy

Understanding where M97 sits in the ICD-10-CM classification helps ensure proper coding:

Sub-Codes 7 entries
M97.0Periprosthetic fracture around internal prosthetic hip jointNon-BillableM97.01Periprosthetic fracture around internal prosthetic right hip jointBillableM97.02Periprosthetic fracture around internal prosthetic left hip jointBillableM97.1Periprosthetic fracture around internal prosthetic knee jointNon-BillableM97.11Periprosthetic fracture around internal prosthetic right knee jointBillableM97.12Periprosthetic fracture around internal prosthetic left knee jointBillableM97.2Periprosthetic fracture around internal prosthetic ankle jointNon-BillableM97.21Periprosthetic fracture around internal prosthetic right ankle jointBillableM97.22Periprosthetic fracture around internal prosthetic left ankle jointBillableM97.3Periprosthetic fracture around internal prosthetic shoulder jointNon-BillableM97.31Periprosthetic fracture around internal prosthetic right shoulder jointBillableM97.32Periprosthetic fracture around internal prosthetic left shoulder jointBillableM97.4Periprosthetic fracture around internal prosthetic elbow jointNon-BillableM97.41Periprosthetic fracture around internal prosthetic right elbow jointBillableM97.42Periprosthetic fracture around internal prosthetic left elbow jointBillableM97.8Periprosthetic fracture around other internal prosthetic jointBillableM97.9Periprosthetic fracture around unspecified internal prosthetic jointBillable
Related Codes

Frequently Asked Questions

Is M97 a billable ICD-10-CM code?

No, M97 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.

What does M97 mean?

M97 is the ICD-10-CM diagnosis code for "Periprosthetic fracture around internal prosthetic joint". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.

What section is M97 in?

M97 is located in Section M97 — "Periprosthetic fracture around internal prosthetic joint" within Chapter 13 of the ICD-10-CM Tabular List.

What are the sub-codes of M97?

M97 has 7 sub-code(s) that provide more specific detail: M97.0, M97.1, M97.2, M97.3, M97.4 and more.

When should I use M97?

Use M97 when the patients documented diagnosis matches "Periprosthetic fracture around internal prosthetic joint" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.

People Also Ask

What is the ICD-10 code for Periprosthetic fracture around internal prosthetic joint?

The ICD-10-CM code for Periprosthetic fracture around internal prosthetic joint is M97.

Can M97 be used for primary diagnosis?

No, M97 is non-billable. Use a more specific sub-code for primary diagnosis billing.

What chapter is M97 in?

M97 is in Chapter 13 of the ICD-10-CM Tabular List.

Is M97 valid for 2026?

Yes, M97 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.

See Also

← PreviousM96.A9Other fracture associated with chest compression and cardiopulmonary resuscitationNext →M97.0Periprosthetic fracture around internal prosthetic hip joint
Code Details
M97
Periprosthetic fracture around internal prosthetic joint
Non-Billable / Non-Specific Code
13 — Diseases of the musculoskeletal system and connective tissue (M00-M99)
M97 — Periprosthetic fracture around internal prosthetic joint
2026 ICD-10-CM