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ICD-10 Guide
ICD-10 CodesS72.03

S72.03

Billable

Midcervical fracture of femur

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

Code Description

ICD-10 S72.03 is a billable code used to indicate a diagnosis of midcervical fracture of femur.

Key Diagnostic Point:

A midcervical fracture of the femur refers to a specific type of fracture that occurs in the neck of the femur, which is the area just below the ball of the hip joint. This type of fracture is particularly common in older adults, often resulting from low-energy falls or trauma. The midcervical region is critical for hip stability and function, and fractures here can lead to significant morbidity, including pain, loss of mobility, and complications such as avascular necrosis. Clinical presentation typically includes hip pain, inability to bear weight, and limited range of motion. Diagnosis is confirmed through imaging studies, such as X-rays or MRI, which can reveal the fracture's location and severity. Treatment often involves surgical intervention, such as internal fixation or hip replacement, depending on the fracture's characteristics and the patient's overall health. Rehabilitation is crucial for recovery, focusing on restoring strength and mobility to prevent future falls and fractures.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and treatment options
  • Need for precise documentation of fracture location and type
  • Potential for complications requiring additional coding
  • Differentiation from other femoral fractures

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to capture associated procedures
  • Misclassification of fracture type
  • Lack of follow-up documentation for complications

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and pre-operative assessments are essential.

Common Clinical Scenarios

Surgical repair of midcervical fractures, management of complications such as non-union or avascular necrosis.

Billing Considerations

Ensure accurate coding of any additional procedures performed during surgery.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive rehabilitation plans, progress notes, and functional assessments.

Common Clinical Scenarios

Post-operative rehabilitation following hip fracture surgery, management of pain and mobility issues.

Billing Considerations

Document functional outcomes and any co-morbid conditions affecting recovery.

Coding Guidelines

Inclusion Criteria

Use S72.03 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture type, location, and any associated procedures
  • Include any relevant external cause codes if applicable

Exclusion Criteria

Do NOT use S72.03 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27125CPT Code

Total hip arthroplasty

Clinical Scenario

Used for patients with severe midcervical fractures requiring joint replacement.

Documentation Requirements

Operative report detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons must document the rationale for choosing arthroplasty over fixation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of femoral fractures, improving data accuracy and enabling better tracking of treatment outcomes and complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of femoral fractures, improving data accuracy and enabling better tracking of treatment outcomes and complications.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of femoral fractures, improving data accuracy and enabling better tracking of treatment outcomes and complications.

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

What is the primary cause of midcervical fractures?

Midcervical fractures are primarily caused by falls, particularly in older adults with weakened bone density due to osteoporosis.