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ICD-10 Guide
ICD-10 CodesS72.012

S72.012

Billable

Unspecified intracapsular fracture of left femur

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

Code Description

ICD-10 S72.012 is a billable code used to indicate a diagnosis of unspecified intracapsular fracture of left femur.

Key Diagnostic Point:

An unspecified intracapsular fracture of the left femur refers to a fracture that occurs within the hip joint capsule, which is a critical area for hip stability and function. This type of fracture is commonly associated with falls, particularly in elderly patients, and can lead to significant morbidity if not managed appropriately. Intracapsular fractures can disrupt the blood supply to the femoral head, increasing the risk of avascular necrosis. Symptoms typically include severe hip pain, inability to bear weight, and limited range of motion. Diagnosis is usually confirmed through imaging studies such as X-rays or MRI. Treatment options may vary from conservative management with pain control and physical therapy to surgical interventions such as internal fixation or hip replacement, depending on the fracture's characteristics and the patient's overall health status. Accurate coding is essential for proper reimbursement and tracking of healthcare outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and locations within the femur
  • Need for precise documentation of the fracture's nature and treatment
  • Potential for complications such as avascular necrosis
  • Differentiation from other types of femoral fractures

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to capture associated conditions (e.g., osteoporosis)
  • Misclassification of fracture type
  • Lack of follow-up documentation post-surgery

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative notes, imaging results, and post-operative care plans.

Common Clinical Scenarios

Surgical repair of intracapsular fractures, management of complications like non-union.

Billing Considerations

Ensure documentation reflects the surgical approach and any complications encountered.

Emergency Medicine

Documentation Requirements

Initial assessment notes, imaging results, and treatment plans.

Common Clinical Scenarios

Evaluation and stabilization of patients with hip fractures post-fall.

Billing Considerations

Document mechanism of injury and any immediate interventions performed.

Coding Guidelines

Inclusion Criteria

Use S72.012 When
  • Follow ICD
  • CM guidelines for coding fractures, ensuring to document the specific site and type of fracture
  • Include any relevant external cause codes if applicable

Exclusion Criteria

Do NOT use S72.012 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27130CPT Code

Total hip arthroplasty

Clinical Scenario

Used in cases where surgical intervention is required for intracapsular fractures.

Documentation Requirements

Operative report detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgery.

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 data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 intracapsular and extracapsular fractures?

Intracapsular fractures occur within the hip joint capsule, while extracapsular fractures occur outside the capsule, affecting different treatment approaches and complications.