M97.12
M97.12: Periprosthetic fracture around internal prosthetic left knee joint
Non-billable headerICD-10-CMleft
M97.12 is a non-billable header ICD-10-CM code for periprosthetic fracture around internal prosthetic left 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
Excludes2 inherited from the categories above M97.12
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with M97.12
Their own Excludes1 notes name this code, so the conflict is not listed above.
- T84.01Broken internal joint prosthesis
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 M97.12
3 child codes. Green means billable.