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ICD-10 Guide
ICD-10 CodesS72.425

S72.425

Billable

Nondisplaced fracture of lateral condyle of left femur

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

Code Description

ICD-10 S72.425 is a billable code used to indicate a diagnosis of nondisplaced fracture of lateral condyle of left femur.

Key Diagnostic Point:

A nondisplaced fracture of the lateral condyle of the left femur refers to a break in the bone that does not result in the bone fragments being misaligned. This type of fracture is often caused by trauma, such as a fall or direct impact to the knee area. The lateral condyle is the outer part of the femur that articulates with the tibia and fibula 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, which can help visualize the fracture and assess any associated soft tissue injuries. Treatment often involves conservative management, including rest, ice, compression, and elevation (RICE), along with immobilization using a brace or splint. In some cases, surgical intervention may be necessary if there is concern for joint instability or if the fracture does not heal properly. Rehabilitation is crucial for restoring function and strength to the knee joint following recovery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between displaced and nondisplaced fractures
  • Understanding the specific anatomical location of the fracture
  • Potential for associated soft tissue injuries
  • Variability in treatment approaches based on patient age and activity level

Audit Risk Factors

  • Inadequate documentation of the fracture type and location
  • Failure to document associated injuries or complications
  • Misclassification of the fracture as displaced
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging reports, and follow-up assessments are essential.

Common Clinical Scenarios

Fractures resulting from sports injuries, falls, or vehicular accidents.

Billing Considerations

Ensure accurate documentation of fracture type and treatment plan, including any surgical interventions.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional status and rehabilitation progress.

Common Clinical Scenarios

Patients undergoing rehabilitation post-fracture for strength and mobility.

Billing Considerations

Document the patient's response to therapy and any modifications to the treatment plan.

Coding Guidelines

Inclusion Criteria

Use S72.425 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture type, location, and any associated injuries
  • Include details from imaging studies and clinical assessments to support the diagnosis

Exclusion Criteria

Do NOT use S72.425 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27405CPT Code

Arthroscopy, knee, diagnostic, with or without synovial biopsy

Clinical Scenario

Used when assessing knee joint injuries, including fractures.

Documentation Requirements

Document the indication for the procedure and findings during the arthroscopy.

Specialty Considerations

Orthopedic surgeons should ensure that the procedure is justified based on clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fractures, including the ability to denote laterality and displacement. This specificity aids in better tracking of treatment outcomes and resource allocation in orthopedic care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, including the ability to denote laterality and displacement. This specificity aids in better tracking of treatment outcomes and resource allocation in orthopedic care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, including the ability to denote laterality and displacement. This specificity aids in better tracking of treatment outcomes and resource allocation in orthopedic care.

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 fracture?

A displaced fracture involves a break in the bone where the ends are misaligned, while a nondisplaced fracture means the bone remains in its normal position despite the fracture.