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ICD-10 Guide
ICD-10 CodesS72.019

S72.019

Billable

Unspecified intracapsular fracture of unspecified femur

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

Code Description

ICD-10 S72.019 is a billable code used to indicate a diagnosis of unspecified intracapsular fracture of unspecified femur.

Key Diagnostic Point:

An unspecified intracapsular fracture of the femur typically refers to a fracture that occurs within the hip joint capsule, which can involve the femoral neck or head. These fractures are often the result of low-energy trauma, such as falls, particularly in older adults with osteoporotic bones. The intracapsular location is significant because it can affect blood supply to the femoral head, increasing the risk of avascular necrosis. Symptoms may 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, which can reveal the fracture's location and severity. Treatment options may vary from conservative management, including pain control and physical therapy, to surgical interventions such as hip arthroplasty or internal fixation, depending on the fracture's characteristics and the patient's overall health. Accurate coding is essential for proper treatment reimbursement and tracking of hip fracture 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 fracture specifics
  • Differentiation from other types of femoral fractures
  • Potential for complications such as avascular necrosis

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to note associated injuries or conditions
  • Misclassification of fracture type
  • Inconsistent coding across different healthcare providers

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Surgical repair of intracapsular fractures, management of complications such as non-union or avascular necrosis.

Billing Considerations

Documentation must clearly indicate the fracture type, location, and any surgical interventions performed.

Emergency Medicine

Documentation Requirements

Initial assessment notes, imaging results, and treatment plans.

Common Clinical Scenarios

Evaluation of patients presenting with hip pain after falls, initial management of fractures.

Billing Considerations

Accurate documentation of mechanism of injury and initial treatment provided is crucial for coding.

Coding Guidelines

Inclusion Criteria

Use S72.019 When
  • Follow ICD
  • CM guidelines for coding fractures, including the need for specificity regarding the fracture type and location
  • Ensure to document the mechanism of injury and any associated conditions

Exclusion Criteria

Do NOT use S72.019 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27130CPT Code

Total hip arthroplasty

Clinical Scenario

Used for patients with severe intracapsular fractures requiring joint replacement.

Documentation Requirements

Operative report detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons must document the fracture type and any pre-existing conditions.

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 data accuracy and treatment tracking. S72.019 provides a broad classification that may require further specification in clinical practice.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving data accuracy and treatment tracking. S72.019 provides a broad classification that may require further specification in clinical practice.

Reimbursement & Billing Impact

reimbursement.

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 significance of specifying the type of femur fracture?

Specifying the type of femur fracture is crucial for determining the appropriate treatment plan, assessing the risk of complications, and ensuring accurate coding for reimbursement purposes.