ICD-10 · PDGM grouping
M96 Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified
All 36 codes in the M96 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
ICD-10-CM FY2027 · CMS grouper v07.2.26
Codes in family
36
Can lead a claim
32
Cannot lead a claim
4
What CMS assigns to M96
32 of the 36 codes group to Musculoskeletal Rehabilitation; 4 are assigned no clinical group. None of the 36 is assigned a comorbidity subgroup. 32 of the 36 can lead a claim.
Every code in M96
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| M96.0 | Pseudarthrosis after fusion or arthrodesis | Can lead a claim | E | None |
| M96.1 | Postlaminectomy syndrome, not elsewhere classified | Can lead a claim | E | None |
| M96.2 | Postradiation kyphosis | Can lead a claim | E | None |
| M96.3 | Postlaminectomy kyphosis | Can lead a claim | E | None |
| M96.4 | Postsurgical lordosis | Can lead a claim | E | None |
| M96.5 | Postradiation scoliosis | Can lead a claim | E | None |
| M96.6 Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate | ||||
| M96.62 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate | ||||
| M96.621 | Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, right armCMS: Fx humerus fol insrt ortho implnt/prosth/bone plt, right arm | Can lead a claim | E | None |
| M96.622 | Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, left armCMS: Fx humerus fol insrt ortho implnt/prosth/bone plt, left arm | Can lead a claim | E | None |
| M96.629 | Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified armCMS: Fx humerus fol insrt ortho implnt/prosth/bone plt, unsp arm | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| M96.63 Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate | ||||
| M96.631 | Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate, right armCMS: Fx rad/ulna fol insrt ortho implnt/prosth/bone plt, r arm | Can lead a claim | E | None |
| M96.632 | Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate, left armCMS: Fx rad/ulna fol insrt ortho implnt/prosth/bone plt, left arm | Can lead a claim | E | None |
| M96.639 | Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified armCMS: Fx rad/ulna fol insrt ortho implnt/prosth/bone plt, unsp arm | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| M96.65 | Fracture of pelvis following insertion of orthopedic implant, joint prosthesis, or bone plateCMS: Fx pelvis following insrt ortho implnt/prosth/bone plt | Can lead a claim | E | None |
| M96.66 Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate | ||||
| M96.661 | Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, right legCMS: Fx femur fol insrt ortho implnt/prosth/bone plt, right leg | Can lead a claim | E | None |
| M96.662 | Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, left legCMS: Fx femur fol insrt ortho implnt/prosth/bone plt, left leg | Can lead a claim | E | None |
| M96.669 | Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified legCMS: Fx femur fol insrt ortho implnt/prosth/bone plt, unsp leg | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| M96.67 Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate | ||||
| M96.671 | Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate, right legCMS: Fx tib/fib fol insrt ortho implnt/prosth/bone plt, right leg | Can lead a claim | E | None |
| M96.672 | Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate, left legCMS: Fx tib/fib fol insrt ortho implnt/prosth/bone plt, left leg | Can lead a claim | E | None |
| M96.679 | Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified legCMS: Fx tib/fib fol insrt ortho implnt/prosth/bone plt, unsp leg | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| M96.69 | Fracture of other bone following insertion of orthopedic implant, joint prosthesis, or bone plateCMS: Fx bone following insrt ortho implnt/prosth/bone plt | Can lead a claim | E | None |
| M96.8 Other intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified | ||||
| M96.81 Intraoperative hemorrhage and hematoma of a musculoskeletal structure complicating a procedure | ||||
| M96.810 | Intraoperative hemorrhage and hematoma of a musculoskeletal structure complicating a musculoskeletal system procedureCMS: Intraop hemor/hemtom of a ms structure comp a ms sys proc | Can lead a claim | E | None |
| M96.811 | Intraoperative hemorrhage and hematoma of a musculoskeletal structure complicating other procedureCMS: Intraop hemor/hemtom of a ms structure comp oth procedure | Can lead a claim | E | None |
| M96.82 Accidental puncture and laceration of a musculoskeletal structure during a procedure | ||||
| M96.820 | Accidental puncture and laceration of a musculoskeletal structure during a musculoskeletal system procedureCMS: Acc pnctr & lac of a ms structure during a ms sys procedure | Can lead a claim | E | None |
| M96.821 | Accidental puncture and laceration of a musculoskeletal structure during other procedureCMS: Acc pnctr & lac of a ms structure during oth procedure | Can lead a claim | E | None |
| M96.83 Postprocedural hemorrhage of a musculoskeletal structure following a procedure | ||||
| M96.830 | Postprocedural hemorrhage of a musculoskeletal structure following a musculoskeletal system procedureCMS: Postproc hemor of a ms structure fol a ms sys procedure | Can lead a claim | E | None |
| M96.831 | Postprocedural hemorrhage of a musculoskeletal structure following other procedureCMS: Postproc hemor of a ms structure following other procedure | Can lead a claim | E | None |
| M96.84 Postprocedural hematoma and seroma of a musculoskeletal structure following a procedure | ||||
| M96.840 | Postprocedural hematoma of a musculoskeletal structure following a musculoskeletal system procedureCMS: Postproc hematoma of a ms structure fol a ms sys procedure | Can lead a claim | E | None |
| M96.841 | Postprocedural hematoma of a musculoskeletal structure following other procedureCMS: Postproc hematoma of a ms structure fol other procedure | Can lead a claim | E | None |
| M96.842 | Postprocedural seroma of a musculoskeletal structure following a musculoskeletal system procedureCMS: Postproc seroma of a ms structure fol a ms sys procedure | Can lead a claim | E | None |
| M96.843 | Postprocedural seroma of a musculoskeletal structure following other procedureCMS: Postproc seroma of a ms structure following other procedure | Can lead a claim | E | None |
| M96.89 | Other intraoperative and postprocedural complications and disorders of the musculoskeletal systemCMS: Oth intraop and postproc comp and disorders of the ms sys | Can lead a claim | E | None |
| M96.A Fracture of ribs, sternum and thorax associated with compression of the chest and cardiopulmonary resuscitation | ||||
| M96.A1 | Fracture of sternum associated with chest compression and cardiopulmonary resuscitationCMS: Fx sternum assoc with chest comprsn and cardiopulm resus | Can lead a claim | E | None |
| M96.A2 | Fracture of one rib associated with chest compression and cardiopulmonary resuscitationCMS: Fx one rib assoc with chest comprsn and cardiopulm resus | Can lead a claim | E | None |
| M96.A3 | Multiple fractures of ribs associated with chest compression and cardiopulmonary resuscitationCMS: Mult fx of ribs assoc w chest comprsn and cardiopulm resus | Can lead a claim | E | None |
| M96.A4 | Flail chest associated with chest compression and cardiopulmonary resuscitationCMS: Flail chest assoc with chest comprsn and cardiopulm resus | Can lead a claim | E | None |
| M96.A9 | Other fracture associated with chest compression and cardiopulmonary resuscitationCMS: Other fracture assoc with chest comprsn and cardiopulm resus | Can lead a claim | E | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
The monthly home health regs digest
What CMS changed, what's due next, and what to do about it — one email a month, no fluff. Read the first issue