octoHealth

M97.9XXS

Billable

Periprosthetic fracture around unspecified internal prosthetic joint (sequela)

Chapter 13: Diseases of the musculoskeletal system and connective tissue

Additional Information

From parent codes: M00-M99 (Chapter 13)

Excludes 2 — Not Included HereFrom M00-M99

Excludes2 means 'NOT INCLUDED HERE!' An Excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time.

  • arthropathic psoriasis (L40.5-)
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • compartment syndrome (traumatic) (T79.A-)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
NotesFrom M00-M99

Additional notes from parent codes that apply to this code.

  • Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition

Inpatient DRG Payments

DRG 92222 discharges

Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc

Avg. Medicare Payment

$10,568

Total Payment$12,420
Patient Responsibility$1,852
Hospital Charge$53,634
DRG 92311 discharges

Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc

Avg. Medicare Payment

$10,890

Total Payment$14,385
Patient Responsibility$3,496
Hospital Charge$96,675