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ICD-10 Guide
ICD-10 CodesS72.136

S72.136

Billable

Nondisplaced apophyseal fracture of unspecified femur

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

Code Description

ICD-10 S72.136 is a billable code used to indicate a diagnosis of nondisplaced apophyseal fracture of unspecified femur.

Key Diagnostic Point:

A nondisplaced 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 characterized by the absence of displacement, meaning the bone fragments remain in their normal anatomical position. Such fractures are commonly seen in adolescents and young adults, particularly in those involved in sports or physical activities that place stress on the femur. The unspecified nature of the femur indicates that the specific location of the fracture within the femur is not detailed, which can complicate treatment and management. These fractures can lead to pain, swelling, and limited mobility, and they may require orthopedic evaluation to determine the best course of treatment, which may include rest, physical therapy, or in some cases, surgical intervention. Understanding the implications of this fracture type is crucial for effective management and rehabilitation, as well as for accurate coding and billing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified location of the fracture complicates treatment planning.
  • Differentiating between apophyseal and other types of fractures.
  • Potential for misclassification with other femoral injuries.
  • Documentation must clearly indicate the nature of the fracture.

Audit Risk Factors

  • Inadequate documentation of fracture specifics.
  • Misuse of unspecified codes leading to denials.
  • Failure to document associated injuries or conditions.
  • Inconsistent coding practices across providers.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed notes on the mechanism of injury, physical examination findings, and treatment plan.

Common Clinical Scenarios

Fractures resulting from sports injuries, falls, or trauma.

Billing Considerations

Ensure clear documentation of the fracture type and location to avoid coding errors.

Pediatrics

Documentation Requirements

Growth and development history, as well as activity level of the child.

Common Clinical Scenarios

Fractures in active children or adolescents involved in sports.

Billing Considerations

Consideration of growth plate involvement and potential long-term effects on bone development.

Coding Guidelines

Inclusion Criteria

Use S72.136 When
  • Follow the ICD
  • CM coding guidelines for fractures, ensuring that the documentation supports the use of the specific code
  • Include details about the mechanism of injury and any associated conditions

Exclusion Criteria

Do NOT use S72.136 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27506CPT Code

Open treatment of femoral fracture

Clinical Scenario

Used when surgical intervention is required for fracture repair.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the specifics of the fracture and treatment.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding fractures, which aids in better tracking of injury patterns and outcomes. S72.136 provides a clear designation for nondisplaced apophyseal fractures, improving the accuracy of patient records and billing.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding fractures, which aids in better tracking of injury patterns and outcomes. S72.136 provides a clear designation for nondisplaced apophyseal fractures, improving the accuracy of patient records and billing.

Reimbursement & Billing Impact

billing.

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 the term 'nondisplaced' in this code?

Nondisplaced indicates that the fracture has not caused the bone fragments to move out of their normal alignment, which typically results in a less complicated healing process compared to displaced fractures.