M96.6

M96.6: Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate

Non-billable headerICD-10-CM

M96.6 is a non-billable header ICD-10-CM code for fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes2: not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

complication of internal orthopedic devices, implants or grafts (T84.-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Intraoperative fracture of bone during insertion of orthopedic implant, joint prosthesis, or bone plate

Excludes2 inherited from the categories above M96.6

Not part of this code, but both may be coded when both are present.

Written on M96: Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified

arthropathy following intestinal bypass (M02.0-)
complications of internal orthopedic prosthetic devices, implants and grafts (T84.-)
disorders associated with osteoporosis (M80)
periprosthetic fracture around internal prosthetic joint (M97.-)
presence of functional implants and other devices (Z96-Z97)

Other codes that can never be billed with M96.6

Their own Excludes1 notes name this code, so the conflict is not listed above.

M40Kyphosis and lordosis

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead M96.6

6 child codes. Green means billable.