M97.01XD

Periprosthetic fracture around internal prosthetic right hip joint, subsequent encounter

FY2027Chapter 13: Diseases of the musculoskeletal system and connective tissue/M97 Periprosthetic fracture around internal prosthetic joint

BillableComplete code, valid to report

M97.01XD (also written M9701XD) is a billable ICD-10-CM diagnosis code for periprosthetic fracture around internal prosthetic right hip joint, subsequent encounter. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 36 codes in category M97 (Periprosthetic fracture around internal prosthetic joint). Its 7th character, D, means subsequent encounter. Its coding notes include a Code first instruction and 12 Excludes2 entries.

7th character

Category M97 requires a 7th character. M97.01 has only 5 characters, so a placeholder X fills the 6th position.

Assembled code M97.01XD Open code

Code first

If the underlying condition listed here is present and known, sequence it first.

Inherited from M97 Periprosthetic fracture around internal prosthetic joint
  • , if known, the specific type and cause of fracture, such as traumatic or pathological

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Inherited from M97 Periprosthetic fracture around internal prosthetic joint
  • fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate (M96.6-)
  • breakage (fracture) of prosthetic joint (T84.01-)
Also from chapter/block level (10 notes)
Inherited from Chapter 13 Diseases of the musculoskeletal system and connective tissue
  • arthropathic psoriasis (L40.5-)
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • compartment syndrome (traumatic) (T79.A-)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the Musculoskeletal Rehabilitation clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

Notes

Also from chapter/block level (1 note)
Inherited from Chapter 13 Diseases of the musculoskeletal system and connective tissue
  • Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition