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ICD-10 Guide
ICD-10 CodesS72.031

S72.031

Billable

Displaced midcervical fracture of right femur

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

Code Description

ICD-10 S72.031 is a billable code used to indicate a diagnosis of displaced midcervical fracture of right femur.

Key Diagnostic Point:

A displaced midcervical fracture of the right femur refers to a specific type of fracture occurring in the neck of the femur, which is the upper part of the thigh bone. This injury is characterized by a break in the bone that has shifted from its original position, leading to misalignment. Such fractures are commonly associated with falls, particularly in elderly patients, and can result in significant morbidity due to complications such as avascular necrosis, nonunion, or malunion. The midcervical region is particularly vulnerable due to its anatomical structure and the forces exerted during trauma. Treatment typically involves surgical intervention, such as internal fixation or hip replacement, depending on the patient's age, activity level, and overall health. Post-operative rehabilitation is crucial for restoring mobility and function. Accurate coding of this fracture is essential for appropriate treatment planning, reimbursement, and tracking of outcomes in orthopedic trauma surgery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the fracture location (midcervical)
  • Displacement status must be clearly documented
  • Differentiation from other types of femoral fractures
  • Potential for co-morbid conditions affecting treatment

Audit Risk Factors

  • Inadequate documentation of fracture displacement
  • Failure to specify the exact location of the fracture
  • Misclassification of fracture type (e.g., displaced vs. non-displaced)
  • Lack of detailed operative reports for surgical interventions

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging reports, and follow-up assessments are essential to support the diagnosis and treatment plan.

Common Clinical Scenarios

Patients presenting with hip pain after a fall, elderly patients with osteoporosis, and those requiring surgical intervention for fracture stabilization.

Billing Considerations

Ensure that all imaging studies are documented and correlate with the surgical findings to support the coding.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional status and rehabilitation goals post-surgery.

Common Clinical Scenarios

Patients undergoing rehabilitation after hip fracture surgery, focusing on mobility and strength training.

Billing Considerations

Documenting progress notes that reflect the patient's recovery trajectory and any complications encountered.

Coding Guidelines

Inclusion Criteria

Use S72.031 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the fracture type, location, and displacement status are accurately documented
  • Include any relevant external cause codes if applicable

Exclusion Criteria

Do NOT use S72.031 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27125CPT Code

Total hip arthroplasty

Clinical Scenario

Used for patients with severe displacement and comminution requiring joint replacement.

Documentation Requirements

Operative report detailing the procedure and indication for surgery.

Specialty Considerations

Orthopedic surgeons must document the pre-operative assessment and post-operative care plan.

27506CPT Code

Open treatment of femoral neck fracture

Clinical Scenario

Used for surgical fixation of displaced midcervical fractures.

Documentation Requirements

Detailed operative notes and imaging studies to support the surgical intervention.

Specialty Considerations

Ensure that the surgical approach and fixation method are clearly documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding fractures, improving the accuracy of data collection and reimbursement processes. S72.031 provides detailed information about the fracture type, which is crucial for treatment planning and outcome tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding fractures, improving the accuracy of data collection and reimbursement processes. S72.031 provides detailed information about the fracture type, which is crucial for treatment planning and outcome tracking.

Reimbursement & Billing Impact

reimbursement processes. S72.031 provides detailed information about the fracture type, which is crucial for treatment planning and outcome tracking.

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 significance of coding S72.031 accurately?

Accurate coding of S72.031 is crucial for ensuring appropriate treatment, reimbursement, and tracking of patient outcomes. It reflects the severity and complexity of the injury, which impacts surgical decisions and rehabilitation strategies.