S72.011B
S72.011B — Unspecified intracapsular fracture of right femur, initial encounter for open fracture type I or II
Billable / specific codeICD-10-CMright
S72.011B is a billable, specific ICD-10-CM code for unspecified intracapsular fracture of right femur, initial encounter for open fracture type i or ii. It is valid for submission on a claim.
7th character "B" — initial encounter for open fracture type I or II
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
Risk adjustment
S72.011B risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 402 Hip Fracture/Dislocation0.467 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
S72.011B is named in 7 Medicare coverage policies — 7 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52465Knee Orthoses - Policy Article
- A52465Knee Orthoses - Policy Article
- A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
- A56421Billing and Coding: CT of the Abdomen and Pelvis
Related codes at this level
Codes that share S72.011. If S72.011B is not quite right, the correct code is usually one of these.
- S72.011AUnspecified intracapsular fracture of right femur, initial encounter for closed fracture
- S72.011CUnspecified intracapsular fracture of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.011DUnspecified intracapsular fracture of right femur, subsequent encounter for closed fracture with routine healing
- S72.011EUnspecified intracapsular fracture of right femur, subsequent encounter for open fracture type I or II with routine healing
- S72.011FUnspecified intracapsular fracture of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.011GUnspecified intracapsular fracture of right femur, subsequent encounter for closed fracture with delayed healing
- S72.011HUnspecified intracapsular fracture of right femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.011JUnspecified intracapsular fracture of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.011KUnspecified intracapsular fracture of right femur, subsequent encounter for closed fracture with nonunion
- S72.011MUnspecified intracapsular fracture of right femur, subsequent encounter for open fracture type I or II with nonunion
- S72.011NUnspecified intracapsular fracture of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.011PUnspecified intracapsular fracture of right femur, subsequent encounter for closed fracture with malunion
- S72.011QUnspecified intracapsular fracture of right femur, subsequent encounter for open fracture type I or II with malunion
- S72.011RUnspecified intracapsular fracture of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.011SUnspecified intracapsular fracture of right femur, sequela
Questions about S72.011B
- Is S72.011B a billable ICD-10-CM code?
- Yes. S72.011B is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.011B 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).