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
Risk adjustment
M96.6 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead M96.6
6 child codes. Green means billable.
- M96.62Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate
- M96.63Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate
- M96.65Fracture of pelvis following insertion of orthopedic implant, joint prosthesis, or bone plate
- M96.66Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate
- M96.67Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate
- M96.69Fracture of other bone following insertion of orthopedic implant, joint prosthesis, or bone plate
Related codes at this level
Codes that share M96. If M96.6 is not quite right, the correct code is usually one of these.
- M96.0Pseudarthrosis after fusion or arthrodesis
- M96.1Postlaminectomy syndrome, not elsewhere classified
- M96.2Postradiation kyphosis
- M96.3Postlaminectomy kyphosis
- M96.4Postsurgical lordosis
- M96.5Postradiation scoliosis
- M96.8Other intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified
- M96.AFracture of ribs, sternum and thorax associated with compression of the chest and cardiopulmonary resuscitation
Questions about M96.6
- Is M96.6 a billable ICD-10-CM code?
- No. M96.6 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does M96.6 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified (M96).