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ICD-10 Guide
ICD-10 CodesS72.04

S72.04

Billable

Fracture of base of neck of femur

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

Code Description

ICD-10 S72.04 is a billable code used to indicate a diagnosis of fracture of base of neck of femur.

Key Diagnostic Point:

A fracture of the base of the neck of the femur is a specific type of hip fracture that occurs just below the ball of the hip joint. This injury is commonly seen in older adults, particularly those with osteoporosis, and can result from low-energy falls or high-energy trauma. The fracture can lead to significant morbidity, including pain, loss of mobility, and complications such as avascular necrosis or nonunion. Clinical presentation typically includes severe hip pain, inability to bear weight, and a characteristic external rotation of the affected leg. Diagnosis is confirmed through imaging studies, primarily X-rays, which may reveal the fracture line and any displacement. Treatment often involves surgical intervention, such as internal fixation or hip replacement, depending on the fracture's stability and the patient's overall health. Rehabilitation is crucial for restoring function and preventing complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and locations
  • Need for precise documentation of fracture characteristics
  • Potential for multiple associated injuries
  • Differentiation from other hip-related injuries

Audit Risk Factors

  • Inadequate documentation of fracture details
  • Failure to specify laterality
  • Misclassification of fracture type
  • Inconsistent coding of associated injuries

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Surgical repair of hip fractures, management of complications, and follow-up care.

Billing Considerations

Ensure accurate documentation of fracture type, location, and surgical approach.

Emergency Medicine

Documentation Requirements

Comprehensive assessment notes, imaging interpretations, and initial treatment plans.

Common Clinical Scenarios

Initial evaluation of hip fractures, pain management, and referral for surgical intervention.

Billing Considerations

Document mechanism of injury and any associated injuries to support coding.

Coding Guidelines

Inclusion Criteria

Use S72.04 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture's specifics, including laterality and type
  • Include any associated conditions that may affect treatment and recovery

Exclusion Criteria

Do NOT use S72.04 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27130CPT Code

Total hip arthroplasty

Clinical Scenario

Used for patients with severe fractures requiring joint replacement.

Documentation Requirements

Operative report detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons must document the reason for choosing arthroplasty over fixation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hip fractures, improving the accuracy of data collection and reimbursement processes. S72.04 provides a clear distinction for fractures of the base of the neck of the femur, which aids in treatment planning and outcome tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hip fractures, improving the accuracy of data collection and reimbursement processes. S72.04 provides a clear distinction for fractures of the base of the neck of the femur, which aids in treatment planning and outcome tracking.

Reimbursement & Billing Impact

reimbursement processes. S72.04 provides a clear distinction for fractures of the base of the neck of the femur, which aids in treatment planning and outcome tracking.

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 S72.04 and S72.03?

S72.04 specifically refers to fractures of the base of the neck of the femur, while S72.03 is a more general code for neck fractures without specifying the base.