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 v07.2.26.
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.
Code families in M97-M97
One page per three-character family: every code in it, whether it can lead a claim, its clinical group and comorbidity subgroup.
Every code in M97-M97
Descriptions are CMS’s own, abbreviated as CMS abbreviates them.
| Code | Description | Clinical group | Primary position |
|---|---|---|---|
| M9701XA | Periprosth fracture around internal prosth r hip jt, init | E | Can lead a claim, code first applies |
| M9701XD | Periprosth fracture around internal prosth r hip jt, subs | E | Can lead a claim, code first applies |
| M9701XS | Periprosth fracture around internal prosth r hip jt, sequela | E | Can lead a claim, code first applies |
| M9702XA | Periprosth fracture around internal prosth l hip jt, init | E | Can lead a claim, code first applies |
| M9702XD | Periprosth fracture around internal prosth l hip jt, subs | E | Can lead a claim, code first applies |
| M9702XS | Periprosth fracture around internal prosth l hip jt, sequela | E | Can lead a claim, code first applies |
| M9711XA | Periprosth fracture around internal prosth r knee jt, init | E | Can lead a claim, code first applies |
| M9711XD | Periprosth fracture around internal prosth r knee jt, subs | E | Can lead a claim, code first applies |
| M9711XS | Periprosth fx around internal prosth r knee jt, sequela | E | Can lead a claim, code first applies |
| M9712XA | Periprosth fracture around internal prosth l knee jt, init | E | Can lead a claim, code first applies |
| M9712XD | Periprosth fracture around internal prosth l knee jt, subs | E | Can lead a claim, code first applies |
| M9712XS | Periprosth fx around internal prosth l knee jt, sequela | E | Can lead a claim, code first applies |
| M9721XA | Periprosth fx around internal prosth r ankle joint, init | E | Can lead a claim, code first applies |
| M9721XD | Periprosth fx around internal prosth r ankle joint, subs | E | Can lead a claim, code first applies |
| M9721XS | Periprosth fx around internal prosth r ankle joint, sequela | E | Can lead a claim, code first applies |
| M9722XA | Periprosth fx around internal prosth l ankle joint, init | E | Can lead a claim, code first applies |
| M9722XD | Periprosth fx around internal prosth l ankle joint, subs | E | Can lead a claim, code first applies |
| M9722XS | Periprosth fx around internal prosth l ankle joint, sequela | E | Can lead a claim, code first applies |
| M9731XA | Periprosth fx around internal prosth r shoulder jt, init | E | Can lead a claim, code first applies |
| M9731XD | Periprosth fx around internal prosth r shoulder jt, subs | E | Can lead a claim, code first applies |
| M9731XS | Periprosth fx around internal prosth r shoulder jt, sequela | E | Can lead a claim, code first applies |
| M9732XA | Periprosth fx around internal prosth l shoulder jt, init | E | Can lead a claim, code first applies |
| M9732XD | Periprosth fx around internal prosth l shoulder jt, subs | E | Can lead a claim, code first applies |
| M9732XS | Periprosth fx around internal prosth l shoulder jt, sequela | E | Can lead a claim, code first applies |
| M9741XA | Periprosth fx around internal prosth r elbow joint, init | E | Can lead a claim, code first applies |
| M9741XD | Periprosth fx around internal prosth r elbow joint, subs | E | Can lead a claim, code first applies |
| M9741XS | Periprosth fx around internal prosth r elbow joint, sequela | E | Can lead a claim, code first applies |
| M9742XA | Periprosth fx around internal prosth l elbow joint, init | E | Can lead a claim, code first applies |
| M9742XD | Periprosth fx around internal prosth l elbow joint, subs | E | Can lead a claim, code first applies |
| M9742XS | Periprosth fx around internal prosth l elbow joint, sequela | E | Can lead a claim, code first applies |
| M978XXA | Periprosth fracture around other internal prosth joint, init | E | Can lead a claim, code first applies |
| M978XXD | Periprosth fracture around other internal prosth joint, subs | E | Can lead a claim, code first applies |
| M978XXS | Periprosth fx around other internal prosth joint, sequela | E | Can lead a claim, code first applies |
| M979XXA | Periprosth fracture around unsp internal prosth joint, init | None | Cannot lead a claim |
| M979XXD | Periprosth fracture around unsp internal prosth joint, subs | None | Cannot lead a claim |
| M979XXS | Periprosth fx around unsp internal prosth joint, sequela | None | Cannot lead a claim |
Source: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01. 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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