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ICD-10 Guide
ICD-10 CodesS72.422

S72.422

Billable

Displaced fracture of lateral condyle of left femur

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

Code Description

ICD-10 S72.422 is a billable code used to indicate a diagnosis of displaced fracture of lateral condyle of left femur.

Key Diagnostic Point:

A displaced fracture of the lateral condyle of the left femur is a specific type of fracture that occurs in the distal femur, affecting the lateral condyle, which is the outer part of the femur that articulates with the tibia at the knee joint. This injury is often the result of high-impact trauma, such as falls or vehicular accidents, and can lead to significant complications if not treated properly. The displacement of the fracture indicates that the bone fragments have moved out of their normal alignment, which can compromise the stability of the knee joint and affect the patient's ability to bear weight. Symptoms typically include severe pain, swelling, and difficulty in moving the knee. Diagnosis is confirmed through imaging studies, such as X-rays or MRI, which help assess the extent of the fracture and any associated injuries. Treatment often involves orthopedic intervention, which may include surgical fixation to realign the bone fragments and restore function. Rehabilitation is crucial for recovery, focusing on restoring range of motion and strength to prevent long-term disability.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the fracture location (lateral condyle)
  • Need for accurate documentation of displacement
  • Potential for associated injuries (e.g., ligament damage)
  • Variability in treatment approaches (surgical vs. conservative)

Audit Risk Factors

  • Inadequate documentation of fracture type and displacement
  • Failure to document associated injuries
  • Incorrect coding of laterality (left vs. right)
  • Misinterpretation of imaging results

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

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

Common Clinical Scenarios

Fractures resulting from sports injuries, falls, or accidents requiring surgical intervention.

Billing Considerations

Ensure clear documentation of fracture type, displacement, and any surgical procedures performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional status and rehabilitation progress.

Common Clinical Scenarios

Patients undergoing rehabilitation post-fracture repair to regain mobility and strength.

Billing Considerations

Documenting the impact of the fracture on daily activities and the rehabilitation plan.

Coding Guidelines

Inclusion Criteria

Use S72.422 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the fracture's location, type, and laterality
  • Include any associated injuries or complications in the coding process

Exclusion Criteria

Do NOT use S72.422 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27405CPT Code

Open treatment of femoral condyle fracture

Clinical Scenario

Used when surgical intervention is performed for a displaced fracture of the lateral condyle.

Documentation Requirements

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

Specialty Considerations

Orthopedic surgeons must document the surgical approach and fixation method used.

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. S72.422 provides detailed information that can impact treatment decisions and 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. S72.422 provides detailed information that can impact treatment decisions and outcomes.

Reimbursement & Billing Impact

reimbursement processes. S72.422 provides detailed information that can impact treatment decisions and 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 significance of the displacement in S72.422?

Displacement indicates that the fracture fragments are not aligned, which can affect joint stability and healing. Accurate coding of displacement is crucial for treatment planning and reimbursement.