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v1.0.0
ICD-10 Guide
ICD-10 CodesS72.036

S72.036

Billable

Nondisplaced midcervical fracture of unspecified femur

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

Code Description

ICD-10 S72.036 is a billable code used to indicate a diagnosis of nondisplaced midcervical fracture of unspecified femur.

Key Diagnostic Point:

A nondisplaced midcervical fracture of the femur refers to a break in the femur that occurs in the midcervical region, which is located near the neck of the femur. This type of fracture is characterized by the absence of displacement, meaning the bone fragments remain in their normal anatomical position. Such fractures are often seen in elderly patients due to falls or in younger individuals due to high-impact trauma. The midcervical area is critical for hip function, and fractures here can lead to significant pain, limited mobility, and complications such as avascular necrosis if not properly managed. Treatment typically involves conservative management with pain control, physical therapy, and in some cases, surgical intervention to stabilize the fracture. Accurate coding is essential for appropriate treatment planning and reimbursement, as well as for tracking outcomes in orthopedic trauma surgery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and locations
  • Need for precise documentation of fracture characteristics
  • Differentiation from displaced fractures
  • Potential for co-existing injuries in trauma cases

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Misclassification of fracture type (displaced vs. nondisplaced)
  • Failure to document co-existing conditions
  • Inconsistent coding across providers

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with hip pain after a fall, elderly patients with osteoporosis, and trauma patients with multiple injuries.

Billing Considerations

Ensure that the documentation clearly states the nondisplaced nature of the fracture and any associated injuries.

Emergency Medicine

Documentation Requirements

Initial assessment notes, imaging results, and any immediate interventions performed in the emergency setting.

Common Clinical Scenarios

Patients presenting to the ER after falls, motor vehicle accidents, or sports injuries.

Billing Considerations

Document the mechanism of injury and any relevant patient history that may affect treatment.

Coding Guidelines

Inclusion Criteria

Use S72.036 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the fracture is coded based on the specific site and type
  • Include any relevant external cause codes if applicable

Exclusion Criteria

Do NOT use S72.036 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 nondisplaced fractures that do not heal properly.

Documentation Requirements

Operative reports detailing the procedure and indications for surgery.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgical intervention.

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 nondisplaced fractures, which aids in better tracking and management of orthopedic injuries.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, including nondisplaced fractures, which aids in better tracking and management of orthopedic injuries.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of fractures, including nondisplaced fractures, which aids in better tracking and management of orthopedic injuries.

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 midcervical fracture?

A displaced midcervical fracture involves a separation of the bone fragments, while a nondisplaced fracture means the fragments remain aligned. This distinction is crucial for treatment and coding.