DxCodebookFY2027 · Oct 1, 2026 – Sep 30, 2027

Category · FY2027

M97 Periprosthetic fracture around internal prosthetic joint

  • Header · not billable
  • Codes take a 7th character

M97 is not billable. The category heads 36 billable codes in FY2027, grouped under 7 subdivisions. Its codes take a 7th character, so none is complete with fewer than 7 characters.

Index → code

  • Fracture, pathological (pathologic)periprosthetic → M97.9
  • Fracture, traumatic (abduction) (adduction) (separation)periprosthetic, around internal prosthetic joint → M97.9
  • Fracture, pathological (pathologic)periprosthetichip → M97.0-

Where it sits

  1. Chapter 13 Diseases of the musculoskeletal system and connective tissue (M00-M99)
  2. M97 Periprosthetic fracture around internal prosthetic joint (M97)
  3. M97 Periprosthetic fracture around internal prosthetic joint
Billable codes
36
Subdivisions
7
CC / MCC codes
12 / 0
HCC V28 codes
2
New FY2027
0
Index entries
21

Codes in M97

  1. M97.0
    Periprosthetic fracture around internal prosthetic hip joint
    Header
  2. M97.01
    Periprosthetic fracture around internal prosthetic right hip joint +7th: A D S
    Needs 7th characterCC A402 (some 7th characters)Exempt: 2 of 3 7th characters
  3. M97.02
    Periprosthetic fracture around internal prosthetic left hip joint +7th: A D S
    Needs 7th characterCC A402 (some 7th characters)Exempt: 2 of 3 7th characters
  4. M97.1
    Periprosthetic fracture around internal prosthetic knee joint
    Header
  5. M97.11
    Periprosthetic fracture around internal prosthetic right knee joint +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  6. M97.12
    Periprosthetic fracture around internal prosthetic left knee joint +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  7. M97.2
    Periprosthetic fracture around internal prosthetic ankle joint
    Header
  8. M97.21
    Periprosthetic fracture around internal prosthetic right ankle joint +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  9. M97.22
    Periprosthetic fracture around internal prosthetic left ankle joint +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  10. M97.3
    Periprosthetic fracture around internal prosthetic shoulder joint
    Header
  11. M97.31
    Periprosthetic fracture around internal prosthetic right shoulder joint +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  12. M97.32
    Periprosthetic fracture around internal prosthetic left shoulder joint +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  13. M97.4
    Periprosthetic fracture around internal prosthetic elbow joint
    Header
  14. M97.41
    Periprosthetic fracture around internal prosthetic right elbow joint +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  15. M97.42
    Periprosthetic fracture around internal prosthetic left elbow joint +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
  16. M97.8
    Periprosthetic fracture around other internal prosthetic joint +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters
    Inclusion terms 4, Use additional code 1

    Inclusion terms

    • Periprosthetic fracture around internal prosthetic finger joint
    • Periprosthetic fracture around internal prosthetic spinal joint
    • Periprosthetic fracture around internal prosthetic toe joint
    • Periprosthetic fracture around internal prosthetic wrist joint

    Use additional code

    • code to identify the joint (Z96.6-) Z96.6
  17. M97.9
    Periprosthetic fracture around unspecified internal prosthetic joint +7th: A D S
    Needs 7th characterCC AExempt: 2 of 3 7th characters

CC/MCC: as a secondary diagnosis, unless the principal diagnosis is on the code’s PDX exclusion list (MS-DRG v44 Appendix C; list on the code card).

Sources of each column. Rows marked +7th need a 7th character: pick one to build the full code; its code card has its own flags.

Instructions

At M97

Excludes2

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

Code first

  • , if known, the specific type and cause of fracture, such as traumatic or pathological

Notes that also apply

Chapter 13 instructions (Notes 1, Excludes2 10): printed on the chapter 13 page.

7th characters

7th characters for M97 defined here

The appropriate 7th character is to be added to each code from category M97

7th characters for M97
7thMeaning (NCHS)
Ainitial encounter
Dsubsequent encounter
Ssequela

A code that takes a 7th character is invalid without it; the placeholder X fills a code shorter than 6 characters (Official Guidelines I.A.5). How 7th characters work.

Index entries

  • Fracture, pathological (pathologic)periprosthetic → M97.9
  • Fracture, traumatic (abduction) (adduction) (separation)periprosthetic, around internal prosthetic joint → M97.9
  • Fracture, pathological (pathologic)periprosthetichip → M97.0-
  • Fracture, traumatic (abduction) (adduction) (separation)periprosthetic, around internal prosthetic jointhip → M97.0-
  • Fracture, pathological (pathologic)periprostheticknee → M97.1-
  • Fracture, pathological (pathologic)periprostheticankle → M97.2-
  • Fracture, traumatic (abduction) (adduction) (separation)periprosthetic, around internal prosthetic jointankle → M97.2-
  • Fracture, pathological (pathologic)periprostheticshoulder → M97.3-
  • Fracture, traumatic (abduction) (adduction) (separation)periprosthetic, around internal prosthetic jointshoulder → M97.3-
  • Fracture, pathological (pathologic)periprostheticelbow → M97.4-
  • Fracture, traumatic (abduction) (adduction) (separation)periprosthetic, around internal prosthetic jointelbow → M97.4-
  • Fracture, pathological (pathologic)periprostheticfinger → M97.8
  • Fracture, pathological (pathologic)periprostheticother specified joint → M97.8
  • Fracture, pathological (pathologic)periprostheticspinal joint → M97.8
  • Fracture, pathological (pathologic)periprosthetictoe joint → M97.8
  • Fracture, pathological (pathologic)periprostheticwrist joint → M97.8
  • Fracture, traumatic (abduction) (adduction) (separation)periprosthetic, around internal prosthetic jointfinger → M97.8
  • Fracture, traumatic (abduction) (adduction) (separation)periprosthetic, around internal prosthetic jointspecified joint NEC → M97.8
  • Fracture, traumatic (abduction) (adduction) (separation)periprosthetic, around internal prosthetic jointspine → M97.8
  • Fracture, traumatic (abduction) (adduction) (separation)periprosthetic, around internal prosthetic jointtoe → M97.8
  • Fracture, traumatic (abduction) (adduction) (separation)periprosthetic, around internal prosthetic jointwrist → M97.8

NCHS Alphabetic Index. Index first, then the Tabular List.