M96.662

Billable

Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, left leg

HCC Category Mapping

V24HCC 176 — Complications of Specified Implanted Device or Graft

0.529

ESRDHCC 176 — Complications of Specified Implanted Device or Graft

0.000

What This Code Means

A fracture of the thighbone (femur) on the left side that occurs as a complication following the insertion of an orthopedic implant, prosthesis, or bone plate.

Coding Tips

•This code is specific to the left leg; use M96.661 for right leg or M96.669 if laterality is unspecified
•Verify the fracture is documented as occurring after the orthopedic procedure to distinguish it from the original injury

Clinical Significance

Left femur fracture following orthopedic implant insertion represents a severe postoperative complication affecting critical weight-bearing function. This diagnosis significantly impacts risk adjustment due to mobility limitations, complex surgical management needs, and potential for extended rehabilitation and care coordination.

Documentation Requirements

✓Clear documentation of prior orthopedic implant, prosthesis, or bone plate insertion
✓Confirmation of left femur fracture occurring subsequent to implant procedure
✓Specific identification of left leg as the affected anatomical site
✓Temporal relationship between implant placement and fracture occurrence
✓Comprehensive management plan for fracture treatment and implant assessment
✓Evaluation of weight-bearing status and ambulatory capacity
✓Clinical documentation excluding external traumatic causes
✓Provider statement confirming complication relationship to orthopedic procedure

Commonly Confused Codes

S72.92XA — Fracture of left femur without implant complication relationship M96.661 — Same complication but affecting right leg rather than left T84.052A — Periprosthetic fracture around internal prosthetic left hip joint M96.669 — Same complication but unspecified leg rather than specifically left Z96.642 — Presence of left artificial hip joint without complications

Code Hierarchy

└M96Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified └M96.6Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate └M96.66Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate └M96.662Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, left leg

└M96.662Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, left leg