Periprosthetic fracture around internal prosthetic right knee joint, initial encounter
Billable / specific
M97.11XA is a billable, specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes in FY2027.
Inclusion terms
Includes (from M97)
- Note: Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
Excludes2
Not included here — may be reported together when both conditions exist.
- arthropathic psoriasis (L40.5-) (from M97)
- certain conditions originating in the perinatal period (P04-P96) (from M97)
- certain infectious and parasitic diseases (A00-B99) (from M97)
- compartment syndrome (traumatic) (T79.A-) (from M97)
- complications of pregnancy, childbirth and the puerperium (O00-O9A) (from M97)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99) (from M97)
- endocrine, nutritional and metabolic diseases (E00-E88) (from M97)
- injury, poisoning and certain other consequences of external causes (S00-T88) (from M97)
- neoplasms (C00-D49) (from M97)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94) (from M97)
- fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate (M96.6-) (from M97)
- breakage (fracture) of prosthetic joint (T84.01-) (from M97)
Code first
Sequence the underlying condition first.
- , if known, the specific type and cause of fracture, such as traumatic or pathological (from M97)
7th character
The 7th character values that apply to this code (defined at M97). Use the placeholder "X" for missing positions.
| Character | Meaning |
|---|---|
| A | initial encounter |
| D | subsequent encounter |
| S | sequela |
Parent code
- M97.11Periprosthetic fracture around internal prosthetic right knee jointNeeds 7th char