M97.1
M97.1 — Periprosthetic fracture around internal prosthetic knee joint
Non-billable headerICD-10-CM
M97.1 is a non-billable header ICD-10-CM code for periprosthetic fracture around internal prosthetic knee joint. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
The appropriate 7th character is to be added to each code from category M97
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
M97.1 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 M97.1
2 child codes. Green means billable.
Related codes at this level
Codes that share M97. If M97.1 is not quite right, the correct code is usually one of these.
- M97.0Periprosthetic fracture around internal prosthetic hip joint
- M97.2Periprosthetic fracture around internal prosthetic ankle joint
- M97.3Periprosthetic fracture around internal prosthetic shoulder joint
- M97.4Periprosthetic fracture around internal prosthetic elbow joint
- M97.8Periprosthetic fracture around other internal prosthetic joint
- M97.9Periprosthetic fracture around unspecified internal prosthetic joint
Questions about M97.1
- Is M97.1 a billable ICD-10-CM code?
- No. M97.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does M97.1 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Periprosthetic fracture around internal prosthetic joint (M97).