Is S72 a billable ICD-10-CM code?

No. S72 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does S72 sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the hip and thigh (S70-S79).

What cannot be coded together with S72?

S72 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

S72

S72 — Fracture of femur

Non-billable headerICD-10-CM

S72 is a non-billable header ICD-10-CM code for fracture of femur. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

The appropriate 7th character is to be added to all codes from category S72

A: initial encounter for closed fracture
B: initial encounter for open fracture type I or II
C: initial encounter for open fracture type IIIA, IIIB, or IIIC
D: subsequent encounter for closed fracture with routine healing
E: subsequent encounter for open fracture type I or II with routine healing
F: subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
G: subsequent encounter for closed fracture with delayed healing
H: subsequent encounter for open fracture type I or II with delayed healing
J: subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
K: subsequent encounter for closed fracture with nonunion
M: subsequent encounter for open fracture type I or II with nonunion
N: subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
P: subsequent encounter for closed fracture with malunion
Q: subsequent encounter for open fracture type I or II with malunion
R: subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
S: sequela

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

traumatic amputation of hip and thigh (S78.-)

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

fracture of lower leg and ankle (S82.-)
fracture of foot (S92.-)
periprosthetic fracture of prosthetic implant of hip (M97.0-)

Notes

Additional guidance from the ICD-10-CM tabular list.

A fracture not indicated as displaced or nondisplaced should be coded to displaced
A fracture not indicated as open or closed should be coded to closed
The open fracture designations are based on the Gustilo open fracture classification

Other codes that can never be billed with S72

These codes carry an Excludes1 note pointing at S72. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S72 alone.

M84.3Stress fracture
M84.4Pathological fracture, not elsewhere classified
S71Open wound of hip and thigh
S72.45Supracondylar fracture without intracondylar extension of lower end of femur
S72.46Supracondylar fracture with intracondylar extension of lower end of femur
S72.9Unspecified fracture of femur
S79.0Physeal fracture of upper end of femur

Risk adjustment

S72 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead S72

7 child codes. Green means billable.

Questions about S72

Is S72 a billable ICD-10-CM code?: No. S72 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does S72 sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the hip and thigh (S70-S79).
What cannot be coded together with S72?: S72 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.