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ICD-10 Guide
ICD-10 CodesS72.309

S72.309

Billable

Unspecified fracture of shaft of unspecified femur

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

Code Description

ICD-10 S72.309 is a billable code used to indicate a diagnosis of unspecified fracture of shaft of unspecified femur.

Key Diagnostic Point:

The S72.309 code refers to an unspecified fracture of the shaft of the femur, which is a common injury often resulting from trauma, such as falls or vehicular accidents. The femur, being the longest and strongest bone in the body, can sustain various types of fractures, including transverse, oblique, or spiral fractures. This code is used when the specific type of fracture is not documented, making it essential for coders to ensure that all relevant clinical details are captured in the medical record. Fractures of the femur can lead to significant morbidity, including pain, loss of mobility, and complications such as nonunion or malunion. Treatment typically involves orthopedic intervention, which may include surgical fixation or conservative management depending on the fracture's characteristics and the patient's overall health. Accurate coding is crucial for appropriate reimbursement and to reflect the severity of the injury in the patient's medical history.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity in documentation regarding the type of fracture.
  • Variability in treatment approaches based on fracture characteristics.
  • Potential for misclassification with other femoral injuries.
  • Need for comprehensive clinical details to support coding.

Audit Risk Factors

  • Insufficient documentation to support the unspecified nature of the fracture.
  • Inconsistent coding practices across different providers.
  • Failure to capture additional injuries or complications.
  • Lack of clarity in the medical record regarding the mechanism of injury.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Fractures resulting from falls in elderly patients, sports injuries in younger patients, and trauma from accidents.

Billing Considerations

Ensure that all relevant details about the fracture type, location, and treatment are documented to avoid unspecified coding.

Emergency Medicine

Documentation Requirements

Thorough documentation of the mechanism of injury, initial assessment, and any imaging performed.

Common Clinical Scenarios

Patients presenting with acute pain and swelling after trauma, requiring immediate evaluation and management.

Billing Considerations

Accurate coding is critical for appropriate triage and treatment pathways; ensure that all injuries are documented.

Coding Guidelines

Inclusion Criteria

Use S72.309 When
  • According to ICD
  • 10 coding guidelines, fractures should be coded based on the specific site and type
  • 309 is used when the specific type of fracture is not documented
  • Coders should ensure that all relevant clinical information is captured to support the use of this code

Exclusion Criteria

Do NOT use S72.309 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27506CPT Code

Open treatment of femoral shaft fracture

Clinical Scenario

Used when surgical intervention is performed for a femoral shaft fracture.

Documentation Requirements

Operative report detailing the procedure, indication for surgery, and post-operative care.

Specialty Considerations

Orthopedic surgeons must provide detailed documentation to support the surgical procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding fractures, but the use of unspecified codes like S72.309 can lead to challenges in accurately reflecting patient care and outcomes. Coders must ensure that they capture all relevant details to avoid potential reimbursement issues.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding fractures, but the use of unspecified codes like S72.309 can lead to challenges in accurately reflecting patient care and outcomes. Coders must ensure that they capture all relevant details to avoid potential reimbursement issues.

Reimbursement & Billing Impact

reimbursement issues.

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 S72.309?

Use S72.309 when the documentation indicates a fracture of the shaft of the femur but does not specify the type of fracture. Ensure that all relevant clinical details are captured to support this coding.