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M96.6 vs M97.32XD

M96.6 (Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate) compared with M97.32XD (Periprosthetic fracture around internal prosthetic left shoulder joint, subsequent encounter), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Relationship

Informational

Excludes2 relationship

M96.6
Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate
↔
M97.32XD
Periprosthetic fracture around internal prosthetic left shoulder joint, subsequent encounter

Distinct conditions — both may be reported.

“periprosthetic fracture around internal prosthetic joint (M97.-)”

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source: CMS ICD-10-CM tabular instructional notes

Can these codes be reported together?

Yes, when both are documented. M96.6 carries an Excludes2 note covering M97.32XD: “periprosthetic fracture around internal prosthetic joint (M97.-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

M96.6Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plateM97.32XDPeriprosthetic fracture around internal prosthetic left shoulder joint, subsequent encounter
Billing statusNon-billable headerBillable
ClassificationM00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
DefinitionFracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate is a non-billable ICD-10-CM category code (M96.6).Periprosthetic fracture around internal prosthetic left shoulder joint, subsequent encounter is a billable ICD-10-CM diagnosis code (M97.32D).
7th character—The appropriate 7th character is to be added to each code from category M97
Includes
Intraoperative fracture of bone during insertion of orthopedic implant, joint prosthesis, or bone plate
—
Code first—
, if known, the specific type and cause of fracture, such as traumatic or pathological
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Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources