M97.0 vs S72.90XK
M97.0 (Periprosthetic fracture around internal prosthetic hip joint) compared with S72.90XK (Unspecified fracture of unspecified femur, subsequent encounter for closed fracture with nonunion), 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. S72.90XK 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.
Side by side
| M97.0Periprosthetic fracture around internal prosthetic hip joint | S72.90XKUnspecified fracture of unspecified femur, subsequent encounter for closed fracture with nonunion | |
|---|---|---|
| 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). | Unspecified fracture of unspecified femur, subsequent encounter for closed fracture with nonunion is a billable ICD-10-CM diagnosis code (S72.90K). |
| 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