M97.42
M97.42 — Periprosthetic fracture around internal prosthetic left elbow joint
Non-billable headerICD-10-CMleft
M97.42 is a non-billable header ICD-10-CM code for periprosthetic fracture around internal prosthetic left elbow 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
M97.42 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 M97.42
3 child codes. Green means billable.
Related codes at this level
Codes that share M97.4. If M97.42 is not quite right, the correct code is usually one of these.
Questions about M97.42
- Is M97.42 a billable ICD-10-CM code?
- No. M97.42 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does M97.42 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).