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ICD-10 Guide
ICD-10 CodesS72.413

S72.413

Billable

Displaced unspecified condyle fracture of lower end of unspecified femur

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

Code Description

ICD-10 S72.413 is a billable code used to indicate a diagnosis of displaced unspecified condyle fracture of lower end of unspecified femur.

Key Diagnostic Point:

A displaced condyle fracture of the lower end of the femur is a significant orthopedic injury that typically occurs due to high-energy trauma, such as falls or vehicular accidents. This type of fracture involves the distal femur, specifically affecting the condyles, which are the rounded ends of the femur that articulate with the tibia at the knee joint. The displacement of the fracture can lead to misalignment of the knee joint, resulting in pain, swelling, and impaired mobility. Patients may present with an inability to bear weight on the affected leg and may exhibit signs of knee instability. Diagnosis is confirmed through imaging studies, including X-rays or CT scans, which reveal the fracture's location and displacement. Treatment often involves surgical intervention to realign the bone fragments and stabilize the fracture, followed by rehabilitation to restore function. Complications can include nonunion, malunion, and post-traumatic arthritis, making accurate coding essential for proper management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture presentation and displacement
  • Need for precise documentation of the fracture type and location
  • Potential for co-existing injuries in polytrauma patients
  • Differentiation from similar fracture codes

Audit Risk Factors

  • Inadequate documentation of fracture details
  • Failure to specify laterality or displacement
  • Misclassification of fracture type
  • Inconsistent coding of associated injuries

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed operative reports, imaging results, and post-operative notes are essential for accurate coding.

Common Clinical Scenarios

Fractures resulting from falls, sports injuries, or motor vehicle accidents.

Billing Considerations

Ensure that all relevant details about the fracture type, location, and treatment are documented to support coding.

Emergency Medicine

Documentation Requirements

Thorough documentation of initial assessment, imaging, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with acute knee pain and inability to bear weight following trauma.

Billing Considerations

Accurate initial coding is crucial for subsequent orthopedic referrals and treatment plans.

Coding Guidelines

Inclusion Criteria

Use S72.413 When
  • Follow ICD
  • CM guidelines for coding fractures, including the need for specificity regarding the type and location of the fracture
  • Ensure to document the mechanism of injury and any associated conditions

Exclusion Criteria

Do NOT use S72.413 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27447CPT Code

Open treatment of distal femoral fracture

Clinical Scenario

Used when surgical intervention is performed to stabilize the fracture.

Documentation Requirements

Operative report detailing the procedure, materials used, and post-operative care.

Specialty Considerations

Orthopedic surgeons must ensure that the fracture type is clearly documented to support the procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding fractures, which is crucial for appropriate treatment and reimbursement. S72.413 reflects the need for detailed documentation to capture the complexity of femoral injuries.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding fractures, which is crucial for appropriate treatment and reimbursement. S72.413 reflects the need for detailed documentation to capture the complexity of femoral injuries.

Reimbursement & Billing Impact

reimbursement. S72.413 reflects the need for detailed documentation to capture the complexity of femoral injuries.

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 significance of specifying displacement in femur fractures?

Specifying displacement is crucial as it affects treatment options, prognosis, and coding accuracy. Displaced fractures often require surgical intervention, while non-displaced fractures may be managed conservatively.