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ICD-10 Guide
ICD-10 CodesS72.09

S72.09

Billable

Other fracture of head and neck of femur

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

Code Description

ICD-10 S72.09 is a billable code used to indicate a diagnosis of other fracture of head and neck of femur.

Key Diagnostic Point:

The S72.09 code refers to fractures occurring in the head and neck of the femur that do not fall into more specific categories. These fractures can result from various mechanisms, including falls, trauma, or pathological conditions. The head and neck of the femur are critical areas for hip stability and mobility, and fractures here can lead to significant morbidity, particularly in older adults. 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. Treatment may involve surgical intervention, such as internal fixation or hip replacement, depending on the fracture's nature and the patient's overall health. Rehabilitation is crucial for recovery, focusing on restoring mobility and strength. Understanding the nuances of this code is essential for accurate billing and ensuring appropriate care pathways are followed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of fracture types within the category
  • Need for precise documentation of fracture specifics
  • Potential for co-existing conditions affecting treatment
  • Variability in treatment approaches based on patient demographics

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to capture co-morbid conditions
  • Misclassification of fracture type
  • Lack of clarity in treatment plans

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 neck fractures, hip arthroplasty for displaced fractures.

Billing Considerations

Ensure documentation reflects the complexity of the fracture and any surgical interventions performed.

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Initial evaluation of hip fractures in trauma patients, stabilization of fractures.

Billing Considerations

Document mechanism of injury and any immediate interventions performed.

Coding Guidelines

Inclusion Criteria

Use S72.09 When
  • Follow the official ICD
  • CM guidelines for coding fractures, including the need for specificity in documentation and the use of additional codes for any associated conditions

Exclusion Criteria

Do NOT use S72.09 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 fracture type and any complications.

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. S72.09 provides a broader category for fractures that may not fit into more specific classifications, allowing for better tracking of treatment outcomes.

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. S72.09 provides a broader category for fractures that may not fit into more specific classifications, allowing for better tracking of treatment outcomes.

Reimbursement & Billing Impact

reimbursement processes. S72.09 provides a broader category for fractures that may not fit into more specific classifications, allowing for better tracking of treatment outcomes.

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 S72.09 and S72.01?

S72.09 is used for other fractures of the head and neck of the femur that do not fit into more specific categories, while S72.01 is specifically for intracapsular fractures.