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ICD-10 Guide
ICD-10 CodesS72.00

S72.00

Billable

Fracture of unspecified part of neck of femur

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/25/2025

Code Description

ICD-10 S72.00 is a billable code used to indicate a diagnosis of fracture of unspecified part of neck of femur.

Key Diagnostic Point:

The fracture of the neck of the femur, commonly referred to as a hip fracture, is a significant orthopedic injury that typically occurs in older adults due to falls or trauma. The neck of the femur is the region just below the ball of the hip joint, and fractures in this area can lead to severe complications, including impaired mobility, chronic pain, and increased risk of mortality. These fractures can be classified as intracapsular or extracapsular, but when coded as S72.00, the specific part of the neck is unspecified. This code is often used when the exact location of the fracture is not documented, which can complicate treatment planning and prognosis. Management of these fractures may involve surgical intervention, such as hip pinning or hip replacement, and rehabilitation to restore function. Accurate coding is essential for appropriate treatment reimbursement and tracking of patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity in documentation regarding the exact location of the fracture.
  • Variability in treatment approaches based on fracture type and patient health status.
  • Potential for misclassification with other types of femoral fractures.
  • Need for comprehensive understanding of orthopedic terminology and anatomy.

Audit Risk Factors

  • Inadequate documentation of fracture specifics.
  • Failure to capture associated injuries or comorbidities.
  • Inconsistent coding practices among different providers.
  • Misalignment between clinical documentation and coded data.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed descriptions of the fracture type, location, and treatment plan.

Common Clinical Scenarios

Surgical repair of hip fractures, post-operative care, and rehabilitation.

Billing Considerations

Ensure that all surgical notes clearly indicate the fracture type and any complications.

Emergency Medicine

Documentation Requirements

Accurate assessment of injury mechanism, initial imaging results, and treatment provided.

Common Clinical Scenarios

Initial evaluation of patients presenting with hip pain after a fall.

Billing Considerations

Documenting the patient's functional status and any pre-existing conditions that may affect treatment.

Coding Guidelines

Inclusion Criteria

Use S72.00 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the code is used when the specific part of the neck of the femur is not documented

Exclusion Criteria

Do NOT use S72.00 When
  • Exclude cases where the fracture is specified or when other codes are more appropriate

Related ICD-10 Codes

Related CPT Codes

27125CPT Code

Total hip arthroplasty

Clinical Scenario

Used for patients with severe neck of femur fractures requiring joint replacement.

Documentation Requirements

Operative report detailing the procedure and indication for surgery.

Specialty Considerations

Orthopedic surgeons must document the fracture type and any complications during surgery.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of fractures, improving specificity and enhancing the ability to track outcomes and resource utilization. However, the use of unspecified codes like S72.00 can lead to challenges in data analysis and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of fractures, improving specificity and enhancing the ability to track outcomes and resource utilization. However, the use of unspecified codes like S72.00 can lead to challenges in data analysis and reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

When should I use S72.00 instead of a more specific code?

Use S72.00 when the documentation does not specify the exact location of the fracture, and no other specific codes apply.