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ICD-10 Guide
ICD-10 CodesS72.13

S72.13

Billable

Apophyseal fracture of femur

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

Code Description

ICD-10 S72.13 is a billable code used to indicate a diagnosis of apophyseal fracture of femur.

Key Diagnostic Point:

An apophyseal fracture of the femur refers to a fracture occurring at the site of an apophysis, which is a bony outgrowth where muscles and tendons attach. This type of fracture is particularly common in adolescents and young adults due to the ongoing development of the skeletal system. The femur, being the longest and strongest bone in the body, can sustain significant trauma leading to such fractures, especially in sports-related injuries or falls. The hip region is particularly vulnerable, as the femoral neck and greater trochanter are common sites for these injuries. Clinically, patients may present with hip pain, inability to bear weight, and limited range of motion. Diagnosis typically involves imaging studies such as X-rays or MRI to confirm the fracture and assess for any associated injuries. Treatment may vary from conservative management with rest and physical therapy to surgical intervention, depending on the severity and displacement of the fracture. Understanding the nuances of apophyseal fractures is crucial for orthopedic trauma surgery, as these injuries can significantly impact a patient's mobility and quality of life.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and severity of fractures
  • Need for precise documentation of fracture type and location
  • Differentiation from other types of femoral fractures
  • Potential for associated injuries requiring additional coding

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to capture associated injuries or complications
  • Misclassification of fracture type
  • Lack of clarity in treatment plans

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Sports injuries, falls in elderly patients, and trauma from accidents.

Billing Considerations

Ensure accurate representation of the fracture's impact on mobility and function.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessment of functional limitations and rehabilitation goals.

Common Clinical Scenarios

Post-operative rehabilitation following surgical repair of apophyseal fractures.

Billing Considerations

Focus on long-term outcomes and functional recovery metrics.

Coding Guidelines

Inclusion Criteria

Use S72.13 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the fracture is documented with the appropriate level of detail
  • Include any associated injuries or complications in the coding process

Exclusion Criteria

Do NOT use S72.13 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27447CPT Code

Open treatment of femoral neck fracture

Clinical Scenario

Used in cases where surgical intervention is required for apophyseal fractures.

Documentation Requirements

Detailed operative notes and imaging results.

Specialty Considerations

Orthopedic surgeons must document the specifics of the fracture and the surgical approach.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fractures, including apophyseal fractures, which aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, including apophyseal fractures, which aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, including apophyseal fractures, which aids in better tracking of treatment outcomes and resource allocation.

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 an apophyseal fracture?

An apophyseal fracture is a type of fracture that occurs at the site of an apophysis, which is a bony outgrowth where muscles and tendons attach, commonly seen in adolescents.