M97.8XXA
Periprosthetic fracture around other internal prosthetic joint, initial encounter
M97.8XXA (also written M978XXA) is a billable ICD-10-CM diagnosis code for periprosthetic fracture around other internal prosthetic joint, initial 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). The Alphabetic Index lists it under 10 entries. Its 7th character, A, means initial encounter. Its coding notes include a Code first instruction, a Use additional code instruction and 12 Excludes2 entries.
7th character
Category M97 requires a 7th character. M97.8 has only 4 characters, so a placeholder X fills the empty positions.
Code first
If the underlying condition listed here is present and known, sequence it first.
- , if known, the specific type and cause of fracture, such as traumatic or pathological
Use additional code
Add the listed code as a secondary code, if known.
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (10 notes)
- 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, 2026Hospital CC
Counts as a complication or comorbidity (CC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 193 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.
Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix CInclusion terms
Conditions classified to this code.
- Periprosthetic fracture around internal prosthetic finger joint
- Periprosthetic fracture around internal prosthetic spinal joint
- Periprosthetic fracture around internal prosthetic toe joint
- Periprosthetic fracture around internal prosthetic wrist joint
Notes
Also from chapter/block level (1 note)
- Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
Alphabetic Index terms
Terms the official Alphabetic Index lists for M97.8. This code adds the 7th character. 10 entries
- Fracture, pathological (pathologic), periprosthetic, finger
- Fracture, pathological (pathologic), periprosthetic, other specified joint
- Fracture, pathological (pathologic), periprosthetic, spinal joint
- Fracture, pathological (pathologic), periprosthetic, toe joint
- Fracture, pathological (pathologic), periprosthetic, wrist joint
- Fracture, traumatic (abduction) (adduction) (separation), periprosthetic, around internal prosthetic joint, finger
- Fracture, traumatic (abduction) (adduction) (separation), periprosthetic, around internal prosthetic joint, specified joint NEC
- Fracture, traumatic (abduction) (adduction) (separation), periprosthetic, around internal prosthetic joint, spine
- Fracture, traumatic (abduction) (adduction) (separation), periprosthetic, around internal prosthetic joint, toe
- Fracture, traumatic (abduction) (adduction) (separation), periprosthetic, around internal prosthetic joint, wrist