M97.1 vs S82.61XF
M97.1 (Periprosthetic fracture around internal prosthetic knee joint) compared with S82.61XF (Displaced fracture of lateral malleolus of right fibula, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing), 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. S82.61XF 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 joint | S82.61XFDisplaced fracture of lateral malleolus of right fibula, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing | |
|---|---|---|
| Billing status | Non-billable header Report instead: M97.11XA, M97.11XD, M97.11XS, M97.12XA, M97.12XD | 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 knee joint is a non-billable ICD-10-CM category code (M97.1). | Displaced fracture of lateral malleolus of right fibula, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing is a billable ICD-10-CM diagnosis code (S82.61F). |
| 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 S82 |
| Includes | — | fracture of malleolus |
| 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