ICD-10 · PDGM grouping

M97-M97 — Periprosthetic fracture around internal prosthetic joint

Every ICD-10-CM code in this range and the PDGM clinical group CMS assigns to it, read from the CMS grouper crosswalk v07.1.26.

OASIS-E2 v1.00.0 · ingested 2026-04-26

Codes in range

36

No clinical group

3

A period cannot be grouped from these.

Barred as primary

0

CMS rejects these in the primary position.

Where these codes group

33 of the 36 codes in M97-M97 group to Musculoskeletal Rehabilitation. A further 3 are assigned no clinical group at all, which means a 30-day period cannot be grouped from them.

Every code in M97-M97

Descriptions are CMS’s own, abbreviated as CMS abbreviates them.

CodeDescriptionClinical groupPrimary position
M9701XAPeriprosth fracture around internal prosth r hip jt, initEAccepted
M9701XDPeriprosth fracture around internal prosth r hip jt, subsEAccepted
M9701XSPeriprosth fracture around internal prosth r hip jt, sequelaEAccepted
M9702XAPeriprosth fracture around internal prosth l hip jt, initEAccepted
M9702XDPeriprosth fracture around internal prosth l hip jt, subsEAccepted
M9702XSPeriprosth fracture around internal prosth l hip jt, sequelaEAccepted
M9711XAPeriprosth fracture around internal prosth r knee jt, initEAccepted
M9711XDPeriprosth fracture around internal prosth r knee jt, subsEAccepted
M9711XSPeriprosth fx around internal prosth r knee jt, sequelaEAccepted
M9712XAPeriprosth fracture around internal prosth l knee jt, initEAccepted
M9712XDPeriprosth fracture around internal prosth l knee jt, subsEAccepted
M9712XSPeriprosth fx around internal prosth l knee jt, sequelaEAccepted
M9721XAPeriprosth fx around internal prosth r ankle joint, initEAccepted
M9721XDPeriprosth fx around internal prosth r ankle joint, subsEAccepted
M9721XSPeriprosth fx around internal prosth r ankle joint, sequelaEAccepted
M9722XAPeriprosth fx around internal prosth l ankle joint, initEAccepted
M9722XDPeriprosth fx around internal prosth l ankle joint, subsEAccepted
M9722XSPeriprosth fx around internal prosth l ankle joint, sequelaEAccepted
M9731XAPeriprosth fx around internal prosth r shoulder jt, initEAccepted
M9731XDPeriprosth fx around internal prosth r shoulder jt, subsEAccepted
M9731XSPeriprosth fx around internal prosth r shoulder jt, sequelaEAccepted
M9732XAPeriprosth fx around internal prosth l shoulder jt, initEAccepted
M9732XDPeriprosth fx around internal prosth l shoulder jt, subsEAccepted
M9732XSPeriprosth fx around internal prosth l shoulder jt, sequelaEAccepted
M9741XAPeriprosth fx around internal prosth r elbow joint, initEAccepted
M9741XDPeriprosth fx around internal prosth r elbow joint, subsEAccepted
M9741XSPeriprosth fx around internal prosth r elbow joint, sequelaEAccepted
M9742XAPeriprosth fx around internal prosth l elbow joint, initEAccepted
M9742XDPeriprosth fx around internal prosth l elbow joint, subsEAccepted
M9742XSPeriprosth fx around internal prosth l elbow joint, sequelaEAccepted
M978XXAPeriprosth fracture around other internal prosth joint, initEAccepted
M978XXDPeriprosth fracture around other internal prosth joint, subsEAccepted
M978XXSPeriprosth fx around other internal prosth joint, sequelaEAccepted
M979XXAPeriprosth fracture around unsp internal prosth joint, initNoneCannot group
M979XXDPeriprosth fracture around unsp internal prosth joint, subsNoneCannot group
M979XXSPeriprosth fx around unsp internal prosth joint, sequelaNoneCannot group

Source: CMS HH PPS Grouper Software v07.1.26, effective 2026-04-01. 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.

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