ICD-10 Guide

S72

Non-billable

Fracture of femur

Chapter 19:Injury, poisoning and other consequences of external causes

BILLABLE STATUSNo

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/05/2025

Code Description

ICD-10 S72 is a used to indicate a diagnosis of fracture of femur.

Key Diagnostic Point:

The ICD-10 Level 1 Category code S72 refers to fractures of the femur, which is the longest bone in the human body and plays a crucial role in mobility and weight-bearing activities. This category encompasses various types of femoral fractures, including those that occur in the neck, shaft, and distal end of the femur. These fractures can result from traumatic events such as falls, motor vehicle accidents, or sports injuries, and they can vary in severity from simple, non-displaced fractures to complex, comminuted fractures requiring surgical intervention. Understanding the specific type of fracture is essential for appropriate treatment and management, as well as for accurate coding and billing purposes.

Clinically, femur fractures are significant due to their potential complications, including non-union, malunion, and the risk of deep vein thrombosis. The management of these fractures often involves a multidisciplinary approach, including orthopedic surgeons, physical therapists, and rehabilitation specialists. Accurate coding with S72 is essential for capturing the complexity of the injury and ensuring that patients receive the appropriate level of care. Additionally, proper documentation and coding are critical for reimbursement and for tracking outcomes in quality measures related to orthopedic care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

Variety of fracture types
Potential for complications
Need for surgical vs. non-surgical management

Audit Risk Factors

Inaccurate coding of fracture type
Insufficient documentation of treatment
Failure to report complications

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Physical Medicine and Rehabilitation

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The S72 code category has significant clinical and administrative implications. Clinically, accurate coding of femur fractures is vital for tracking patient outcomes, managing complications, and improving quality of care. It allows healthcare providers to analyze trends in fracture incidence and treatment efficacy, which can inform future clinical practices and guidelines. From an administrative perspective, proper coding impacts reimbursement rates and financial health of healthcare facilities. As healthcare trends move towards value-based care, accurate documentation and coding of conditions like femur fractures will be increasingly important for meeting quality measures and improving population health outcomes.

ICD-9 vs ICD-10

Reimbursement & Billing Impact

reimbursement rates and financial health of healthcare facilities. As healthcare trends move towards value-based care, accurate documentation and coding of conditions like femur fractures will be increasingly important for meeting quality measures and improving population health outcomes.

Resources

Clinical References

•
Official ICD-10 Guidelines for S72

Coding & Billing References

•
Official ICD-10 Guidelines for S72

Frequently Asked Questions

What conditions are included in S72?

The S72 category includes various types of femur fractures such as neck fractures, shaft fractures, and distal femur fractures, each with specific subcategories for coding.

When should I use S72 codes?

S72 codes should be used when documenting any fracture of the femur, ensuring to specify the type and location of the fracture for accurate coding.

What documentation is required for S72?

Documentation must include the type of fracture, mechanism of injury, treatment provided, and any complications that arise during the course of care.

ICD-10 S72 is a used to indicate a diagnosis of fracture of femur.

Key Diagnostic Point:

Clinically, femur fractures are significant due to their potential complications, including non-union, malunion, and the risk of deep vein thrombosis. The management of these fractures often involves a multidisciplinary approach, including orthopedic surgeons, physical therapists, and rehabilitation specialists. Accurate coding with S72 is essential for capturing the complexity of the injury and ensuring that patients receive the appropriate level of care. Additionally, proper documentation and coding are critical for reimbursement and for tracking outcomes in quality measures related to orthopedic care.