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M97.1 vs S82.51XM

M97.1 (Periprosthetic fracture around internal prosthetic knee joint) compared with S82.51XM (Displaced fracture of medial malleolus of right tibia, subsequent encounter for open fracture type I or II with nonunion), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Relationship

Informational

Excludes2 relationship

S82.51XM
Displaced fracture of medial malleolus of right tibia, subsequent encounter for open fracture type I or II with nonunion
↔
M97.1
Periprosthetic fracture around internal prosthetic knee joint

Distinct conditions — both may be reported.

“periprosthetic fracture around internal prosthetic implant of knee joint (M97.1-)”

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. S82.51XM carries an Excludes2 note covering M97.1: “periprosthetic fracture around internal prosthetic implant of knee joint (M97.1-)”

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

Side by side

M97.1Periprosthetic fracture around internal prosthetic knee jointS82.51XMDisplaced fracture of medial malleolus of right tibia, subsequent encounter for open fracture type I or II with nonunion
Billing statusNon-billable headerBillable
ClassificationM00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
DefinitionPeriprosthetic fracture around internal prosthetic knee joint is a non-billable ICD-10-CM category code (M97.1).Displaced fracture of medial malleolus of right tibia, subsequent encounter for open fracture type I or II with nonunion is a billable ICD-10-CM diagnosis code (S82.51M).
7th characterThe appropriate 7th character is to be added to each code from category M97The appropriate 7th character is to be added to all codes from category S82
Includes—
fracture of malleolus
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