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ICD-10 Guide
ICD-10 CodesS72.099

S72.099

Billable

Other fracture of head and neck of unspecified femur

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

Code Description

ICD-10 S72.099 is a billable code used to indicate a diagnosis of other fracture of head and neck of unspecified femur.

Key Diagnostic Point:

The S72.099 code is used to classify fractures of the head and neck of the femur that do not fall into more specific categories. These fractures can occur due to 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 in these regions can lead to significant morbidity, particularly in elderly populations. 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 conservative management with pain control and physical therapy or surgical intervention, including internal fixation or hip replacement, depending on the fracture's severity and the patient's overall health. Accurate coding is essential for proper reimbursement and tracking of orthopedic injuries, especially in cases where surgical intervention is required.

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 from other femoral fractures and dislocations
  • Potential for multiple injuries in trauma cases

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to specify laterality (right vs. left)
  • Misclassification of fracture type
  • Inconsistent treatment documentation

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Fractures resulting from falls in elderly patients, sports injuries in younger patients, and trauma from accidents.

Billing Considerations

Ensure that all relevant imaging and surgical interventions are documented to support the coding.

Emergency Medicine

Documentation Requirements

Initial assessment notes, imaging results, and treatment plans must be clearly documented.

Common Clinical Scenarios

Patients presenting with acute hip pain after a fall or trauma.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use S72.099 When
  • According to ICD
  • 10 coding guidelines, S72
  • 099 should be used when the specific type of fracture is not documented
  • Coders should ensure that the documentation supports the diagnosis and that any associated injuries are also coded appropriately

Exclusion Criteria

Do NOT use S72.099 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27130CPT Code

Total hip arthroplasty

Clinical Scenario

Used for severe fractures requiring joint replacement.

Documentation Requirements

Operative report detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons must document the fracture type and treatment rationale.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of femoral fractures, improving the accuracy of data collection and reimbursement processes. S72.099 provides a broader classification for cases where specific details are not available.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of femoral fractures, improving the accuracy of data collection and reimbursement processes. S72.099 provides a broader classification for cases where specific details are not available.

Reimbursement & Billing Impact

reimbursement processes. S72.099 provides a broader classification for cases where specific details are not available.

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 S72.099 instead of a more specific code?

Use S72.099 when the documentation does not specify the exact type of fracture or when the fracture does not fit into a more defined category.