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ICD-10 Guide
ICD-10 CodesS72.36

S72.36

Billable

Segmental fracture of shaft of femur

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

Code Description

ICD-10 S72.36 is a billable code used to indicate a diagnosis of segmental fracture of shaft of femur.

Key Diagnostic Point:

A segmental fracture of the shaft of the femur is characterized by two or more fracture lines in the same bone segment, leading to a fracture that is not a simple break but rather a more complex injury. This type of fracture often occurs due to high-energy trauma, such as motor vehicle accidents or falls from significant heights. Segmental fractures can lead to complications such as non-union or malunion, necessitating careful orthopedic evaluation and management. The femur, being the longest and strongest bone in the body, is crucial for weight-bearing and mobility. Treatment typically involves surgical intervention, including internal fixation with plates or intramedullary nails, to stabilize the fracture and promote healing. Post-operative rehabilitation is essential to restore function and strength. Accurate coding of segmental fractures is vital for appropriate reimbursement and tracking of orthopedic trauma cases, as these injuries often require extensive medical resources and follow-up care.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Multiple fracture lines complicate diagnosis and treatment planning.
  • Potential for associated soft tissue injuries increases coding complexity.
  • Requires detailed documentation of the mechanism of injury.
  • Surgical intervention often involves multiple procedures, impacting coding.

Audit Risk Factors

  • Inadequate documentation of fracture type and location.
  • Failure to document associated injuries or complications.
  • Incorrect coding of surgical procedures performed.
  • Lack of clarity in the mechanism of injury.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and follow-up notes are essential for accurate coding.

Common Clinical Scenarios

Patients presenting with high-energy trauma resulting in segmental femur fractures, often requiring surgical intervention.

Billing Considerations

Ensure all surgical procedures and any complications are documented to support coding.

Emergency Medicine

Documentation Requirements

Thorough documentation of initial assessment, imaging results, and any immediate interventions performed.

Common Clinical Scenarios

Patients with acute trauma presenting to the emergency department with suspected femur fractures.

Billing Considerations

Accurate documentation of the mechanism of injury is crucial for coding.

Coding Guidelines

Inclusion Criteria

Use S72.36 When
  • According to ICD
  • 10 guidelines, S72
  • 36 should be used when a segmental fracture of the femur is confirmed through imaging
  • It is important to document the specific location and nature of the fracture, as well as any associated injuries

Exclusion Criteria

Do NOT use S72.36 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27506CPT Code

Open treatment of femoral shaft fracture

Clinical Scenario

Used in conjunction with S72.36 for surgical fixation of the segmental fracture.

Documentation Requirements

Operative report detailing the procedure performed and any implants used.

Specialty Considerations

Orthopedic surgeons must document the complexity 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 segmental fractures, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of orthopedic trauma cases and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of segmental fractures, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of orthopedic trauma cases and outcomes.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of orthopedic trauma cases and outcomes.

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 difference between a segmental fracture and a simple fracture?

A segmental fracture involves multiple fracture lines in the same bone segment, while a simple fracture is a single break in the bone. Segmental fractures are typically more complex and may require more extensive surgical intervention.