ICD-10-CM 2027 diagnosis code
M97.01XDPeriprosthetic fracture around internal prosthetic right hip joint, subsequent encounter
M97.01XD is a valid, billable ICD-10-CM code for periprosthetic fracture around internal prosthetic right hip joint, subsequent encounter. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.Short description: Periprosth fracture around internal prosth r hip jt, subs
Code last changed in FY2017 (effective October 1, 2016). Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data
About M97.01XD
M97.01XD is the ICD-10-CM diagnosis code for Periprosthetic fracture around internal prosthetic right hip joint, subsequent encounter. It belongs to category M97 (Periprosthetic fracture around internal prosthetic joint), block M97 (Periprosthetic fracture around internal prosthetic joint) and chapter 13 (diseases of the musculoskeletal system and connective tissue). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.
The 7th character "D" means subsequent encounter: use it for encounters after active treatment, while the patient is healing or recovering.
Code first: , if known, the specific type and cause of fracture, such as traumatic or pathological.
It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.
In MS-DRG v44.0, it is part of the grouping logic for DRG 559 (Aftercare, Musculoskeletal System and Connective Tissue with MCC, relative weight 1.8088), DRG 560 (Aftercare, Musculoskeletal System and Connective Tissue with CC, relative weight 1.1238) and DRG 561 (Aftercare, Musculoskeletal System and Connective Tissue without CC/MCC, relative weight 0.8258), in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.
It is exempt from present-on-admission (POA) reporting, so no POA indicator is required.
It was added in FY2017, effective October 1, 2016.
Before ICD-10, this condition was coded in ICD-9-CM as V54.23 (aftercare for healing pathologic fracture of hip).
7th character
Dsubsequent encounter
CC/MCC status for this injury by encounter: CC for A; Neither CC nor MCC for D, S.
Other encounter types for M97.01:
Notes that apply from higher levels
Instructions written at a parent level also apply to M97.01XD.
Broader instructions also apply from Chapter 13: Diseases of the musculoskeletal system and connective tissue.
MS-DRG v44.0 grouping
All DRGs →Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.
MDC 08 · Diseases and Disorders of the Musculoskeletal System and Connective Tissue
ICD-9-CM equivalent
Converter →- V54.23Aftercare for healing pathologic fracture of hipapproximate
From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.
Code history
- 2016
- 2017
- 2018
- 2019
- 2020
- 2021
- 2022
- 2023
- 2024
- 2025
- 2026
- 2027
- FY2017 (effective 10/1/2016): Added
- No changes since FY2017.
Common questions about M97.01XD
Is M97.01XD billable?
- Yes. M97.01XD is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).
What does the "D" at the end of M97.01XD mean?
- It is the 7th character for subsequent encounter. Per the official guidelines, use it for encounters after active treatment, while the patient is healing or recovering.
Can M97.01XD be used as a principal diagnosis?
- Yes. The Medicare Code Editor doesn't restrict M97.01XD as a principal diagnosis.
Is M97.01XD a CC or MCC?
- No. M97.01XD is neither a CC nor an MCC under MS-DRG v44.0.
What DRG does M97.01XD group to?
- M97.01XD is used in the MS-DRG v44.0 logic for MS-DRG 559 (Aftercare, Musculoskeletal System and Connective Tissue with MCC), MS-DRG 560 (Aftercare, Musculoskeletal System and Connective Tissue with CC) and MS-DRG 561 (Aftercare, Musculoskeletal System and Connective Tissue without CC/MCC). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.