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ICD-10/M97.8XXA

M97.8XXA ICD-10-CM Code: Periprosthetic fracture around other internal prosthetic joint, initial encounter

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0 (FY2026), Appendix B.

  • MS-DRG 559 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)
  • MS-DRG 560 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC (MDC 08)
  • MS-DRG 561 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC (MDC 08)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Code Set: Valid FY2026 and FY2027. FY2026 took effect October 1, 2025.

Official Registry Overview & Definition

Periprosthetic fracture around other internal prosthetic joint, initial encounter is a billable ICD-10-CM diagnosis code (M97.8A).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for M97.8XXA in the official ICD-10-CM tabular list.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Periprosthetic fracture around internal prosthetic finger joint
  • Periprosthetic fracture around internal prosthetic spinal joint
  • Periprosthetic fracture around internal prosthetic toe joint
  • Periprosthetic fracture around internal prosthetic wrist joint

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

  • fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate (M96.6-)
  • breakage (fracture) of prosthetic joint (T84.01-)

Code First

Underlying conditions that must be sequenced before this code.

  • Code first, if known, the specific type and cause of fracture, such as traumatic or pathological

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code to identify the joint (Z96.6-)

Frequently Asked Questions (FAQ) & Clinical Guidance

Does M97.8XXA require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category M97.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to M97.8XXA in its code family, with their registry titles.

  • M97.42 — Periprosthetic fracture around internal prosthetic left elbow joint
  • M97.42XA — Periprosthetic fracture around internal prosthetic left elbow joint, initial encounter
  • M97.42XD — Periprosthetic fracture around internal prosthetic left elbow joint, subsequent encounter
  • M97.42XS — Periprosthetic fracture around internal prosthetic left elbow joint, sequela
  • M97.8 — Periprosthetic fracture around other internal prosthetic joint
  • M97.8XXD — Periprosthetic fracture around other internal prosthetic joint, subsequent encounter
  • M97.8XXS — Periprosthetic fracture around other internal prosthetic joint, sequela
  • M97.9 — Periprosthetic fracture around unspecified internal prosthetic joint
  • M97.9XXA — Periprosthetic fracture around unspecified internal prosthetic joint, initial encounter
  • M97.9XXD — Periprosthetic fracture around unspecified internal prosthetic joint, subsequent encounter

View all codes in the M97 family