M97.0 (Periprosthetic fracture around internal prosthetic hip joint) compared with S72.22XS (Displaced subtrochanteric fracture of left femur, sequela), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Distinct conditions — both may be reported.
“periprosthetic fracture of prosthetic implant of hip (M97.0-)”
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
Yes, when both are documented. S72.22XS carries an Excludes2 note covering M97.0: “periprosthetic fracture of prosthetic implant of hip (M97.0-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
| M97.0Periprosthetic fracture around internal prosthetic hip joint | S72.22XSDisplaced subtrochanteric fracture of left femur, sequela | |
|---|---|---|
| Billing status | Non-billable header Report instead: M97.01XA, M97.01XD, M97.01XS, M97.02XA, M97.02XD | 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 | Periprosthetic fracture around internal prosthetic hip joint is a non-billable ICD-10-CM category code (M97.0). | Displaced subtrochanteric fracture of left femur, sequela is a billable ICD-10-CM diagnosis code (S72.22S). |
| 7th character | The appropriate 7th character is to be added to each code from category M97 | The appropriate 7th character is to be added to all codes from category S72 |
| Code first | , if known, the specific type and cause of fracture, such as traumatic or pathological | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources