M96.671

Billable

Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate, right 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 tibia or fibula (lower leg bones) on the right side that develops as a complication after surgical insertion of an orthopedic implant, prosthesis, or bone plate.

Coding Tips

•This code is specific to the right leg; use M96.672 for left leg or M96.679 if laterality is unspecified
•Clarify whether the fracture involves the tibia, fibula, or both in the documentation for clinical accuracy

Clinical Significance

Right tibia or fibula fracture following orthopedic implant insertion represents a significant postoperative complication affecting weight-bearing function. This diagnosis substantially impacts risk adjustment due to mobility limitations, complex surgical management requirements, and potential need for revision procedures.

Documentation Requirements

✓Clear documentation of prior orthopedic implant, prosthesis, or bone plate insertion
✓Confirmation of tibia or fibula fracture occurring after implant procedure
✓Specific identification of right leg involvement
✓Temporal relationship between implant placement and fracture development
✓Treatment plan for fracture management and implant evaluation
✓Assessment of weight-bearing status and ambulatory capacity
✓Documentation excluding external trauma as primary fracture cause
✓Provider statement confirming complication relationship to orthopedic procedure

Commonly Confused Codes

S82.91XA — Fracture of right lower leg without implant relationship M96.679 — Same complication but unspecified leg rather than specifically right T84.053A — Periprosthetic fracture around internal prosthetic right knee joint M96.672 — Same complication but affecting left leg rather than right Z96.653 — Presence of artificial right knee 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 └M96.67Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate └M96.671Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate, right leg

└M96.671Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate, right leg