ICD-10-CM diagnosis code
M97.01XD Periprosthetic fracture around internal prosthetic right hip joint, subsequent encounter
- Billable
- Yes, a complete code (FY2026)
- Category
- M97
Encounter (7th character)
This code is for a subsequent encounter: active treatment is complete and the patient is being seen during healing or recovery (for example a cast change, medication adjustment or follow-up visit).
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Other codes in M97
36 complete codes in this category.
- M97.01XAPeriprosthetic fracture around internal prosthetic right hip joint, initial encounter
- M97.01XDPeriprosthetic fracture around internal prosthetic right hip joint, subsequent encounter
- M97.01XSPeriprosthetic fracture around internal prosthetic right hip joint, sequela
- M97.02XAPeriprosthetic fracture around internal prosthetic left hip joint, initial encounter
- M97.02XDPeriprosthetic fracture around internal prosthetic left hip joint, subsequent encounter
- M97.02XSPeriprosthetic fracture around internal prosthetic left hip joint, sequela
- M97.11XAPeriprosthetic fracture around internal prosthetic right knee joint, initial encounter
- M97.11XDPeriprosthetic fracture around internal prosthetic right knee joint, subsequent encounter
- M97.11XSPeriprosthetic fracture around internal prosthetic right knee joint, sequela
- M97.12XAPeriprosthetic fracture around internal prosthetic left knee joint, initial encounter
- M97.12XDPeriprosthetic fracture around internal prosthetic left knee joint, subsequent encounter
- M97.12XSPeriprosthetic fracture around internal prosthetic left knee joint, sequela
Documentation tips
- Make sure the note supports every element of the title, “Periprosthetic fracture around internal prosthetic right hip joint, subsequent encounter”: each detail in it should be traceable to the history, examination or assessment.
- Code to the highest specificity the documentation supports. If a detail is missing from the note, add it to the note rather than choosing a less specific code by default.
- Check the Tabular List and official guidelines for instructional notes (“code first”, “use additional code”, Excludes1/Excludes2) that apply to M97.
ICD-10-CM is developed by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, and is based on the WHO ICD-10. Codes and titles are reproduced unchanged from the FY2026 code list (effective 1 October 2025). Their use here does not imply endorsement by CDC, HHS or the U.S. Government. Changes effective on or after 1 October 2026 may not be reflected yet; check the current release at cdc.gov or cms.gov before submitting claims.
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