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ICD-10 Guide
ICD-10 CodesS72.126

S72.126

Billable

Nondisplaced fracture of lesser trochanter of unspecified femur

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

Code Description

ICD-10 S72.126 is a billable code used to indicate a diagnosis of nondisplaced fracture of lesser trochanter of unspecified femur.

Key Diagnostic Point:

A nondisplaced fracture of the lesser trochanter of the femur is characterized by a break in the bone that does not result in the separation of the fracture fragments. This type of fracture typically occurs in the context of trauma, such as falls or high-impact sports injuries, and is more common in individuals with weakened bone density, such as the elderly or those with osteoporosis. The lesser trochanter is a small, bony prominence located on the femur, serving as an attachment point for muscles involved in hip flexion and rotation. Although these fractures are less common than other types of hip fractures, they can still lead to significant pain, limited mobility, and complications if not properly managed. Diagnosis is usually confirmed through imaging studies, such as X-rays or MRI, which can help differentiate between nondisplaced and displaced fractures. Treatment often involves conservative management, including rest, pain control, and physical therapy, although surgical intervention may be necessary in certain cases, especially if there is associated instability or if the patient is unable to bear weight.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between displaced and nondisplaced fractures
  • Understanding the anatomical significance of the lesser trochanter
  • Variability in documentation practices among providers
  • Potential for misclassification with other femoral fractures

Audit Risk Factors

  • Inadequate documentation of fracture type
  • Failure to specify laterality or location
  • Misinterpretation of imaging results
  • Inconsistent terminology used in clinical notes

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Fractures resulting from falls, sports injuries, or pathological fractures in osteoporotic patients.

Billing Considerations

Ensure that the documentation clearly states the type of fracture and any associated injuries.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional status and rehabilitation plans.

Common Clinical Scenarios

Patients recovering from hip fractures requiring rehabilitation services.

Billing Considerations

Document the patient's progress and any complications that may arise during rehabilitation.

Coding Guidelines

Inclusion Criteria

Use S72.126 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the fracture is documented as nondisplaced and specifying the femur's location
  • Include any relevant external cause codes if applicable

Exclusion Criteria

Do NOT use S72.126 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27130CPT Code

Total hip arthroplasty

Clinical Scenario

Used in cases where a nondisplaced fracture leads to significant joint dysfunction.

Documentation Requirements

Operative notes detailing the procedure and indications for surgery.

Specialty Considerations

Orthopedic surgeons should ensure that the rationale for surgery is clearly documented.

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. S72.126 provides a clear distinction for nondisplaced fractures, which aids in clinical management and research.

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. S72.126 provides a clear distinction for nondisplaced fractures, which aids in clinical management and research.

Reimbursement & Billing Impact

reimbursement processes. S72.126 provides a clear distinction for nondisplaced fractures, which aids in clinical management and research.

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 a nondisplaced and displaced fracture?

A nondisplaced fracture means that the bone cracks but does not move out of alignment, while a displaced fracture involves the bone fragments moving out of their normal position.