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v1.0.0
ICD-10 Guide
ICD-10 CodesS72.414

S72.414

Billable

Nondisplaced unspecified condyle fracture of lower end of right femur

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

Code Description

ICD-10 S72.414 is a billable code used to indicate a diagnosis of nondisplaced unspecified condyle fracture of lower end of right femur.

Key Diagnostic Point:

A nondisplaced fracture of the condyle at the lower end of the right femur refers to a break in the bone that does not result in the bone fragments being misaligned. This type of fracture is often associated with trauma, such as falls or sports injuries, and can occur in various populations, particularly in older adults due to osteoporosis. The condyle is the rounded end of the femur that articulates with the tibia at the knee joint. Symptoms typically include localized pain, swelling, and limited range of motion in the knee. Diagnosis is usually confirmed through imaging studies such as X-rays or MRI. Treatment may involve conservative management with rest, ice, compression, and elevation (RICE), along with physical therapy, or surgical intervention if necessary. Proper coding is essential for accurate billing and to ensure appropriate treatment protocols are followed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture presentation and symptoms
  • Need for precise documentation of the fracture type and location
  • Differentiation from other femoral fractures
  • Potential for associated injuries in the knee joint

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to document associated injuries
  • Misclassification of fracture type
  • Inconsistent use of imaging results in documentation

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed imaging reports, surgical notes, and follow-up assessments are required to support the diagnosis and treatment plan.

Common Clinical Scenarios

Fractures resulting from falls in elderly patients, sports injuries in younger patients, and post-operative complications.

Billing Considerations

Documentation must clearly indicate the nondisplaced nature of the fracture and any associated injuries to ensure accurate coding.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional limitations and rehabilitation plans are necessary.

Common Clinical Scenarios

Patients undergoing rehabilitation post-fracture, focusing on restoring mobility and strength.

Billing Considerations

Documentation should include progress notes and functional assessments to support ongoing treatment.

Coding Guidelines

Inclusion Criteria

Use S72.414 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the fracture is documented as nondisplaced and specifying the right femur
  • Include any relevant external cause codes if applicable

Exclusion Criteria

Do NOT use S72.414 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27405CPT Code

Arthroplasty, knee, condyle replacement

Clinical Scenario

Used in cases where surgical intervention is required for nondisplaced condyle fractures.

Documentation Requirements

Surgical notes must detail the procedure and rationale for intervention.

Specialty Considerations

Orthopedic surgeons must ensure accurate coding to reflect the complexity of the procedure.

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 accuracy of patient records and billing. S72.414 provides a clear distinction for nondisplaced fractures, which aids in treatment planning and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of patient records and billing. S72.414 provides a clear distinction for nondisplaced fractures, which aids in treatment planning and resource allocation.

Reimbursement & Billing Impact

billing. S72.414 provides a clear distinction for nondisplaced fractures, which aids in treatment planning 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 the difference between a displaced and nondisplaced condyle fracture?

A displaced condyle fracture involves misalignment of the bone fragments, while a nondisplaced fracture means the bone remains in its normal position despite the break.