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ICD-10 Guide
ICD-10 CodesS72.06

S72.06

Billable

Articular fracture of head of femur

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

Code Description

ICD-10 S72.06 is a billable code used to indicate a diagnosis of articular fracture of head of femur.

Key Diagnostic Point:

An articular fracture of the head of the femur is a specific type of hip fracture that occurs at the uppermost part of the femur, where it articulates with the acetabulum of the pelvis. This injury is often the result of high-energy trauma, such as falls or motor vehicle accidents, particularly in older adults with osteoporosis. The fracture can lead to significant complications, including avascular necrosis, where the blood supply to the femoral head is compromised, leading to bone death. Symptoms typically include severe hip pain, inability to bear weight, and limited range of motion. Diagnosis is confirmed through imaging studies, such as X-rays or MRI, which can reveal the extent of the fracture and any associated injuries. Treatment often involves surgical intervention, such as internal fixation or hip replacement, depending on the fracture's complexity and the patient's overall health. Rehabilitation is crucial for restoring function and mobility post-surgery.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires precise documentation of fracture type and location.
  • Differentiation from other types of hip fractures (e.g., intertrochanteric, subtrochanteric).
  • Potential for complications such as avascular necrosis or nonunion.
  • Involvement of multiple specialties (orthopedic surgery, rehabilitation).

Audit Risk Factors

  • Inadequate documentation of fracture specifics.
  • Failure to document associated injuries or complications.
  • Incorrect coding of fracture type leading to reimbursement issues.
  • Lack of clarity in surgical notes regarding the procedure performed.

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Surgical repair of femoral head fractures, management of complications like avascular necrosis.

Billing Considerations

Ensure clear documentation of fracture classification and surgical approach.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive rehabilitation plans, progress notes, and functional assessments.

Common Clinical Scenarios

Post-operative rehabilitation following hip fracture surgery.

Billing Considerations

Document functional goals and progress to support ongoing therapy.

Coding Guidelines

Inclusion Criteria

Use S72.06 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the fracture's location and type
  • Include any associated conditions or complications
  • articular fractures or unrelated injuries

Exclusion Criteria

Do NOT use S72.06 When
  • Exclude codes for non

Related ICD-10 Codes

Related CPT Codes

27130CPT Code

Total hip arthroplasty

Clinical Scenario

Performed for severe articular fractures of the femoral head.

Documentation Requirements

Operative report detailing the procedure and indications.

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, improving the accuracy of data collection and reimbursement processes. S72.06 provides granularity that was not available in ICD-9, facilitating better patient management and outcomes tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of data collection and reimbursement processes. S72.06 provides granularity that was not available in ICD-9, facilitating better patient management and outcomes tracking.

Reimbursement & Billing Impact

reimbursement processes. S72.06 provides granularity that was not available in ICD-9, facilitating better patient management and outcomes 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 S72.06 and S72.05?

S72.06 refers specifically to articular fractures of the head of the femur, while S72.05 pertains to articular fractures of the neck of the femur. Accurate coding depends on the precise location of the fracture.