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ICD-10 Guide
ICD-10 CodesS72.399

S72.399

Billable

Other fracture of shaft of unspecified femur

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

Code Description

ICD-10 S72.399 is a billable code used to indicate a diagnosis of other fracture of shaft of unspecified femur.

Key Diagnostic Point:

The S72.399 code is used to classify fractures of the shaft of the femur that do not fall into more specific categories. These fractures can occur due to various mechanisms, including trauma from falls, vehicular accidents, or sports injuries. The femur, being the longest and strongest bone in the body, can sustain significant force, leading to complex fractures that may involve multiple fragments or displacement. In the context of hip fractures, while S72.399 specifically addresses shaft fractures, it is essential to differentiate these from proximal femur fractures, which are more common in elderly populations due to osteoporosis. Treatment often involves orthopedic intervention, which may include surgical fixation or intramedullary nailing, depending on the fracture's nature and location. Accurate coding is crucial for appropriate management and reimbursement, as well as for tracking outcomes in orthopedic trauma surgery. Understanding the nuances of this code is vital for coders, especially when dealing with cases that may involve multiple injuries or complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and locations
  • Need for precise documentation of injury mechanism
  • Differentiation from other femur fracture codes
  • Potential for associated injuries requiring co-coding

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to capture associated injuries
  • Misclassification of fracture type
  • Lack of clarity on treatment provided

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging results, and notes on fracture characteristics and treatment plans.

Common Clinical Scenarios

Fractures resulting from high-energy trauma, falls in elderly patients, and sports-related injuries.

Billing Considerations

Ensure accurate documentation of fracture type, location, and any surgical interventions performed.

Emergency Medicine

Documentation Requirements

Initial assessment notes, imaging results, and treatment provided in the emergency setting.

Common Clinical Scenarios

Patients presenting with acute trauma, pain, and potential fractures after accidents.

Billing Considerations

Document mechanism of injury and any immediate interventions to support coding.

Coding Guidelines

Inclusion Criteria

Use S72.399 When
  • According to ICD
  • 10 guidelines, S72
  • 399 should be used when the specific type of femoral shaft fracture is not documented
  • Coders must ensure that the documentation supports the use of this code and that it is not used in cases where a more specific code is applicable

Exclusion Criteria

Do NOT use S72.399 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, fracture type, and fixation method.

Specialty Considerations

Orthopedic surgeons must ensure accurate coding based on 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, improving the granularity of data collected for femoral injuries. S72.399 provides a catch-all for unspecified shaft fractures, but coders must ensure that documentation supports its use to avoid denials.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the granularity of data collected for femoral injuries. S72.399 provides a catch-all for unspecified shaft fractures, but coders must ensure that documentation supports its use to avoid denials.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, improving the granularity of data collected for femoral injuries. S72.399 provides a catch-all for unspecified shaft fractures, but coders must ensure that documentation supports its use to avoid denials.

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 S72.399 instead of a more specific femur fracture code?

Use S72.399 when the documentation does not specify the type or location of the femoral shaft fracture, and no more specific code is applicable.