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v1.0.0
ICD-10 Guide
ICD-10 CodesS72.059

S72.059

Billable

Unspecified fracture of head of unspecified femur

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

Code Description

ICD-10 S72.059 is a billable code used to indicate a diagnosis of unspecified fracture of head of unspecified femur.

Key Diagnostic Point:

The S72.059 code refers to an unspecified fracture of the head of the femur, which is a critical area of the hip joint. This type of fracture can occur due to various mechanisms, including falls, trauma, or pathological conditions such as osteoporosis. The head of the femur is essential for hip joint stability and mobility, and fractures in this area can lead to significant morbidity, particularly in elderly patients. Symptoms typically include severe hip pain, inability to bear weight, and limited range of motion. Diagnosis is often confirmed through imaging studies such as X-rays or MRI, which help to visualize the fracture and assess for any associated injuries. Treatment may involve conservative management with pain control and physical therapy or surgical intervention, such as hip arthroplasty or internal fixation, depending on the fracture's severity and the patient's overall health status. The complexity of managing these fractures lies in the need for a multidisciplinary approach, including orthopedic surgeons, physical therapists, and primary care providers, to ensure optimal recovery and rehabilitation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and treatment options
  • Need for precise documentation of fracture location and type
  • Potential for associated injuries in the hip region
  • Variability in patient demographics and comorbidities

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to capture associated injuries or comorbidities
  • Misclassification of fracture type or location
  • Inconsistent use of unspecified codes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging results, and pre- and post-operative assessments.

Common Clinical Scenarios

Surgical repair of femoral head fractures, management of hip dislocations, and treatment of osteoporotic fractures.

Billing Considerations

Ensure accurate documentation of fracture type and treatment plan to support coding.

Physical Therapy

Documentation Requirements

Progress notes detailing rehabilitation goals, treatment modalities, and patient response.

Common Clinical Scenarios

Rehabilitation following hip fracture surgery, gait training, and strength-building exercises.

Billing Considerations

Document functional limitations and progress to justify therapy sessions.

Coding Guidelines

Inclusion Criteria

Use S72.059 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the fracture type is not specified
  • Document any relevant clinical findings and imaging results to support the use of this code

Exclusion Criteria

Do NOT use S72.059 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27130CPT Code

Total hip arthroplasty

Clinical Scenario

Used for surgical treatment of severe femoral head 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 detailed coding of fractures, improving the specificity of patient records and facilitating better treatment planning. However, the use of unspecified codes like S72.059 can lead to challenges in data analysis and quality reporting.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of fractures, improving the specificity of patient records and facilitating better treatment planning. However, the use of unspecified codes like S72.059 can lead to challenges in data analysis and quality reporting.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more detailed coding of fractures, improving the specificity of patient records and facilitating better treatment planning. However, the use of unspecified codes like S72.059 can lead to challenges in data analysis and quality reporting.

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

When should I use S72.059?

Use S72.059 when a patient has an unspecified fracture of the head of the femur, and no further details about the fracture type or location are available.