M96.629 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified arm

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis.

Applies from M96 Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified

Excludes2 (not included here)

• arthropathy following intestinal bypass (M02.0-)
• complications of internal orthopedic prosthetic devices, implants and grafts (T84.-)
• disorders associated with osteoporosis (M80)
• periprosthetic fracture around internal prosthetic joint (M97.-)
• presence of functional implants and other devices (Z96-Z97)

Applies from M96.6 Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate

Applicable to

• Intraoperative fracture of bone during insertion of orthopedic implant, joint prosthesis, or bone plate

Excludes2 (not included here)

• complication of internal orthopedic devices, implants or grafts (T84.-)

Risk adjustment (HCC)

• CMS-HCC V22: HCC 176 — Complications of Specified Implanted Device or Graft
• ESRD V24: HCC 176

MS-DRG index

Defines the logic of DRG(s) 559-561 in MDC 08.

Approximate ICD-9-CM (GEMs)

• 996.49 Other mechanical complication of other internal orthopedic device, implant, and graft (approximate)

Medicare Code Edits (MCE v43.1 (April 2026))

• Unspecified code (laterality): Unspecified codes for which a more specific code identifying laterality (right, left, bilateral) exists within the same code family.

Code annotations containing back-references to M96.629

Back-references to M96.6

• Type 2 Excludes: M97 Periprosthetic fracture around internal prosthetic joint ("fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate (M96.6-)")
• Type 2 Excludes: T84 Complications of internal orthopedic prosthetic devices, implants and grafts ("fracture of bone following insertion of orthopedic implant, joint prosthesis or bone plate (M96.6)")

Back-references to M96

• Type 1 Excludes: M40 Kyphosis and lordosis ("postprocedural kyphosis and lordosis (M96.-)")
• Type 2 Excludes: M95 Other acquired deformities of musculoskeletal system and connective tissue ("postprocedural musculoskeletal disorders (M96.-)")
• Type 2 Excludes: T81 Complications of procedures, not elsewhere classified ("intraoperative and postprocedural complications of specific body system (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95, K91.-, L76.-, M96.-, N99.-)")

Nearby codes

• M96.5 Postradiation scoliosis
• M96.6 Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate
• M96.62 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate
• M96.621 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, right arm
• M96.622 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, left arm
• M96.629 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified arm (this code)
• M96.63 Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate
• M96.631 Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate, right arm
• M96.632 Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate, left arm
• M96.639 Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified arm
• M96.65 Fracture of pelvis following insertion of orthopedic implant, joint prosthesis, or bone plate