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ICD-10 Coding for Periprosthetic Fracture(M97.02XA, M97.02, M84.4)

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Learn how to accurately code periprosthetic fractures using ICD-10 codes, including M97.02XA and S72.XXX, with detailed documentation requirements.

Also known as:
Fracture around prosthetic jointProsthetic joint fracture
Related ICD-10 Code Ranges

Complete code families applicable to Periprosthetic Fracture

M00-M99Primary Range

Diseases of the musculoskeletal system and connective tissue

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Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescription
M97.02XAPeriprosthetic fracture around internal prosthetic joint, initial encounter
S72.402AUnspecified fracture of lower end of left femur, initial encounter
Primary ICD-10-CM Codes
Periprosthetic fracture around internal prosthetic left hip joint, initial encounter
M97.02XABillable
Periprosthetic fracture around internal prosthetic left hip joint
M97.02
Differential Codes

Alternative codes to consider when ruling out similar conditions

Mechanical loosening of prosthetic jointT84.02

Use when there is evidence of prosthesis instability or loosening.

Pathological fracture, right femurM84.451A

Use when fracture is due to underlying bone pathology.

Documentation & Coding Risks

Avoid these common issues when documenting Periprosthetic Fracture.

Omitting laterality in documentation

Impact

Clinical: Ambiguity in treatment planning, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials

Mitigation

Always document left/right/bilateral, Use templates with laterality prompts

Using T84.04- for periprosthetic fracture

Impact

Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with updated ICD-10 guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation

Use M97.XXX + fracture code

Incorrect code sequencing

Impact

Using M97 as primary instead of secondary code.

Mitigation

Educate coders on correct sequencing rules.

Frequently Asked Questions

Related condition guides

Documentation requirements, coding pitfalls and FAQs for conditions coded with M97.02XA.