Question 1

Is M97 a billable ICD-10 code?

Accepted Answer

No, M97 is not a billable code. It is a category code that requires additional specificity. You must select a more specific code from the subcategories for billing purposes.

Question 2

What does ICD-10 code M97 mean?

Accepted Answer

ICD-10-CM code M97 represents Periprosthetic fracture around internal prosthetic joint. This code is part of the International Classification of Diseases, 10th Revision, Clinical Modification used for medical coding and billing in the United States.

Question 3

When was ICD-10 code M97 introduced?

Accepted Answer

Code M97 was added to ICD-10-CM in fiscal year 2017. ICD-10-CM codes are updated annually by the Centers for Medicare & Medicaid Services (CMS) to reflect advances in medical knowledge and clinical practice.

Question 4

What is the parent category for ICD-10 code M97?

Accepted Answer

The parent category for M97 is section:M97 (Periprosthetic fracture around internal prosthetic joint (M97)). This hierarchical classification helps organize related diagnoses for more accurate coding.

Question 5

What conditions should be coded separately from M97?

Accepted Answer

Code M97 has Type 2 Excludes including: fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate (M96.6-); breakage (fracture) of prosthetic joint (T84.01-). These conditions are not included in M97 but can be coded together if the patient has both conditions.

Question 6

Does M97 require a 7th character extension?

Accepted Answer

Yes, M97 requires a 7th character to specify the encounter type. Available extensions include: A (initial encounter), D (subsequent encounter), S (sequela). Use "X" as a placeholder to fill empty positions before the 7th character (e.g., M97XXA for initial encounter). The extension indicates whether this is an initial visit, follow-up, or treatment for a late effect.

M972026

Code First1Sequence another code first

Excludes212Not included here

Notes1Additional information

7th Character Extensions3Encounter type specifiers