M96.672

Billable

Fracture of tibia or fibula 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 tibia or fibula (lower leg bones) on the left 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 left leg; use M96.671 for right leg or M96.679 if laterality is unspecified
•Document which bone (tibia, fibula, or both) is fractured to support the clinical record

Clinical Significance

Left tibia or fibula fracture following orthopedic implant insertion represents a serious postoperative complication affecting critical weight-bearing bones. This diagnosis significantly impacts risk adjustment due to mobility limitations, complex surgical revision needs, and extended rehabilitation requirements.

Documentation Requirements

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

Commonly Confused Codes

S82.92XA — Fracture of left lower leg without implant complication relationship M96.671 — Same complication but affecting right leg rather than left T84.054A — Periprosthetic fracture around internal prosthetic left knee joint M96.679 — Same complication but unspecified leg rather than specifically left Z96.654 — Presence of artificial left 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 └M96.672Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate, left leg

└M96.672Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate, left leg