M96.6 vs T84.50XA
M96.6 (Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate) compared with T84.50XA (Infection and inflammatory reaction due to unspecified internal joint prosthesis, initial encounter), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. M96.6 carries an Excludes2 note covering T84.50XA: “complication of internal orthopedic devices, implants or grafts (T84.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Yes, when both are documented. M96.6 carries an Excludes2 note covering T84.50XA: “complications of internal orthopedic prosthetic devices, implants and grafts (T84.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Yes, when both are documented. T84.50XA carries an Excludes2 note covering M96.6: “fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate (M96.6)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Yes, when both are documented. T84.50XA carries an Excludes2 note covering M96.6: “intraoperative and postprocedural complications of specified body systems (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95.6-, J95.7, K91.6-, L76.-, M96.-, N99.-)”
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 plate | T84.50XAInfection and inflammatory reaction due to unspecified internal joint prosthesis, initial encounter | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| Classification | M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate is a non-billable ICD-10-CM category code (M96.6). | — |
| 7th character | — | The appropriate 7th character is to be added to each code from category T84 |
| Includes | Intraoperative fracture of bone during insertion of orthopedic implant, joint prosthesis, or bone plate | — |
| Use additional code | — | code to identify infection code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5) code(s) to identify the specified condition resulting from the complication |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources