Periprosth fx around unsp internal prosth joint, sequela

This code signifies a fracture occurring in the bone surrounding an artificial joint, where the specific joint involved is not documented. It indicates that the fracture is a late effect or complication of a previous injury or condition, rather than an acute event. This diagnosis typically reflects a chronic or long-term consequence of the prosthetic joint.

Use this code when documentation clearly states a periprosthetic fracture around an internal prosthetic joint, but the specific joint (e.g., hip, knee, shoulder) is not identified. This code is appropriate for encounters addressing the long-term management or sequelae of such a fracture, after the initial healing phase. Supporting documentation would include operative reports, imaging studies, and physician notes detailing the fracture and its chronic nature.

• Ensure the documentation explicitly states "unspecified" or lacks information regarding the specific joint to justify using this code.
• Do not use this code for acute periprosthetic fractures; instead, select a code from the M97.0-M97.8 series with the appropriate seventh character for the encounter.
• Always sequence this code after the primary diagnosis if the sequela is not the main reason for the encounter.