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ICD-10 Guide
ICD-10 CodesS72.423

S72.423

Billable

Displaced fracture of lateral condyle of unspecified femur

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

Code Description

ICD-10 S72.423 is a billable code used to indicate a diagnosis of displaced fracture of lateral condyle of unspecified femur.

Key Diagnostic Point:

A displaced fracture of the lateral condyle of the femur is a specific type of fracture that occurs at the distal end of the femur, affecting the outer portion of the knee joint. This injury is often the result of trauma, such as a fall or a direct blow to the knee, and can lead to significant complications if not treated appropriately. The lateral condyle is critical for knee stability and function, and fractures in this area can disrupt the normal biomechanics of the knee. Symptoms typically include localized pain, swelling, and difficulty bearing weight on the affected leg. Diagnosis is confirmed through imaging studies, such as X-rays or MRI, which reveal the fracture's displacement and any associated soft tissue injuries. Treatment often involves orthopedic intervention, which may include immobilization, surgical fixation, or joint replacement, depending on the fracture's severity and the patient's overall health. Rehabilitation is crucial for restoring function and strength to the knee joint post-injury.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fracture types and locations within the femur.
  • Need for precise documentation of displacement and associated injuries.
  • Differentiation from similar codes related to femoral fractures.
  • Potential for multiple treatment options affecting coding.

Audit Risk Factors

  • Inadequate documentation of fracture type and displacement.
  • Failure to specify the laterality of the fracture.
  • Misclassification of fracture severity.
  • Inconsistent coding of associated injuries.

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 sports injuries, falls in elderly patients, or trauma from vehicle accidents.

Billing Considerations

Documentation must clearly indicate the fracture's displacement and any surgical interventions performed.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessments of functional limitations and rehabilitation progress.

Common Clinical Scenarios

Patients undergoing rehabilitation post-fracture repair or those with complications such as non-union.

Billing Considerations

Focus on functional outcomes and the impact of the fracture on daily activities.

Coding Guidelines

Inclusion Criteria

Use S72.423 When
  • According to ICD
  • 10 guidelines, S72
  • 423 should be used when the fracture is confirmed through imaging and documented as displaced
  • It is essential to include laterality and any associated injuries in the documentation to ensure accurate coding

Exclusion Criteria

Do NOT use S72.423 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

27405CPT Code

Open treatment of distal femoral fracture

Clinical Scenario

Used when surgical intervention is required for displaced fractures.

Documentation Requirements

Operative reports detailing the procedure and any implants used.

Specialty Considerations

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

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. S72.423 provides a clear distinction for displaced fractures, which is crucial for treatment planning and outcome tracking.

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. S72.423 provides a clear distinction for displaced fractures, which is crucial for treatment planning and outcome tracking.

Reimbursement & Billing Impact

reimbursement processes. S72.423 provides a clear distinction for displaced fractures, which is crucial for treatment planning and outcome tracking.

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 S72.423 and S72.422?

S72.423 refers to a displaced fracture of the lateral condyle, while S72.422 refers to a non-displaced fracture. Accurate documentation of the fracture type is essential for correct coding.