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ICD-10 Guide
ICD-10 CodesS72.415

S72.415

Billable

Nondisplaced unspecified condyle fracture of lower end of left femur

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

Code Description

ICD-10 S72.415 is a billable code used to indicate a diagnosis of nondisplaced unspecified condyle fracture of lower end of left femur.

Key Diagnostic Point:

A nondisplaced condyle fracture of the lower end of the left femur refers to a break in the femur bone at the knee joint level, specifically affecting the condyle region, without any displacement of the bone fragments. This type of fracture is often the result of low-energy trauma, such as a fall or a direct blow to the knee. Clinically, patients may present with localized pain, swelling, and limited range of motion in the knee. Diagnosis is typically confirmed through imaging studies, such as X-rays or MRI, which can reveal the fracture's location and characteristics. Treatment usually involves conservative management, including rest, immobilization, and physical therapy, although surgical intervention may be necessary in cases where joint stability is compromised or if there are associated injuries. Understanding the nuances of this fracture type is crucial for orthopedic surgeons and medical coders alike, as it impacts treatment decisions and coding accuracy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture presentation and associated injuries
  • Need for precise documentation of fracture type and location
  • Differentiation from other types of femoral fractures
  • Potential for surgical intervention affecting coding

Audit Risk Factors

  • Inadequate documentation of fracture specifics
  • Failure to note associated injuries or complications
  • Misclassification of fracture type
  • Inconsistent coding of treatment modalities

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed descriptions of the fracture, treatment plan, and any surgical interventions performed.

Common Clinical Scenarios

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

Billing Considerations

Documentation must clearly indicate the nondisplaced nature of the fracture and any associated injuries to ensure accurate coding.

Physical Medicine and Rehabilitation

Documentation Requirements

Assessment of functional limitations and rehabilitation goals post-fracture.

Common Clinical Scenarios

Patients undergoing rehabilitation after a nondisplaced femoral fracture.

Billing Considerations

Focus on recovery outcomes and the impact of the fracture on mobility and daily activities.

Coding Guidelines

Inclusion Criteria

Use S72.415 When
  • According to ICD
  • 10 coding guidelines, S72
  • 415 should be used when the fracture is confirmed as nondisplaced and specifically located at the lower end of the left femur
  • Coders must ensure that the documentation supports the diagnosis and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use S72.415 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27506CPT Code

Open treatment of femoral condyle fracture

Clinical Scenario

Used when surgical intervention is required for a nondisplaced condyle fracture.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons must document the specifics of the fracture and treatment approach.

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 patient records and treatment plans. S72.415 provides a clear indication of the fracture type and location, which is essential for appropriate management and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fractures, improving the accuracy of patient records and treatment plans. S72.415 provides a clear indication of the fracture type and location, which is essential for appropriate management and reimbursement.

Reimbursement & Billing Impact

reimbursement.

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 coding S72.415 accurately?

Accurate coding of S72.415 is essential for proper treatment planning, reimbursement, and tracking of patient outcomes. It ensures that healthcare providers are compensated for the care provided and helps in maintaining accurate medical records.