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v1.0.0
ICD-10 Guide
ICD-10 CodesS72.052

S72.052

Billable

Unspecified fracture of head of left femur

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

Code Description

ICD-10 S72.052 is a billable code used to indicate a diagnosis of unspecified fracture of head of left femur.

Key Diagnostic Point:

An unspecified fracture of the head of the left femur refers to a break in the uppermost part of the femur, which is the long bone in the thigh that connects the hip joint to the knee. This type of fracture is often associated with hip fractures, which can occur due to trauma, such as falls, or as a result of conditions like osteoporosis that weaken the bone. The head of the femur is critical for hip joint stability and mobility, and fractures in this area can lead to significant pain, loss of function, and complications such as avascular necrosis if not treated properly. Treatment typically involves surgical intervention, such as hip arthroplasty or internal fixation, depending on the fracture's severity and the patient's overall health. Accurate coding is essential for appropriate management 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 within the femur
  • Need for precise documentation of fracture characteristics
  • Differentiation between traumatic and pathological fractures
  • Potential for associated injuries in the hip region

Audit Risk Factors

  • Inadequate documentation of fracture details
  • Misclassification of fracture type
  • Failure to document associated injuries
  • Inconsistent coding practices among providers

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging studies, and follow-up notes are essential for accurate coding.

Common Clinical Scenarios

Common scenarios include hip fractures due to falls in elderly patients, fractures from high-impact sports injuries, and fractures in patients with osteoporosis.

Billing Considerations

Coders should ensure that all relevant details about the fracture type, treatment plan, and patient outcomes are documented to support the coding.

Emergency Medicine

Documentation Requirements

Emergency department notes must clearly document the mechanism of injury, initial assessment, and any imaging results.

Common Clinical Scenarios

Patients presenting with acute hip pain after a fall or trauma, requiring immediate evaluation and potential surgical referral.

Billing Considerations

Accurate coding in emergency settings is crucial for proper reimbursement and tracking of trauma cases.

Coding Guidelines

Inclusion Criteria

Use S72.052 When
  • According to ICD
  • CM guidelines, codes for fractures should specify the type and location of the fracture
  • 052 is used when the fracture is unspecified, but additional documentation should clarify the injury's nature

Exclusion Criteria

Do NOT use S72.052 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 reports must detail the procedure and any complications.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgery 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 specificity in coding fractures, improving the ability to track outcomes and treatment effectiveness. S72.052 provides a framework for capturing unspecified fractures, but encourages thorough documentation to support clinical decisions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding fractures, improving the ability to track outcomes and treatment effectiveness. S72.052 provides a framework for capturing unspecified fractures, but encourages thorough documentation to support clinical decisions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specificity in coding fractures, improving the ability to track outcomes and treatment effectiveness. S72.052 provides a framework for capturing unspecified fractures, but encourages thorough documentation to support clinical decisions.

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 S72.052 and S72.001?

S72.052 refers specifically to an unspecified fracture of the head of the left femur, while S72.001 refers to an unspecified fracture of the neck of the femur. The location of the fracture is critical for treatment and coding.