S72.012C
S72.012C — Unspecified intracapsular fracture of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
Billable / specific codeICD-10-CMleft
S72.012C is a billable, specific ICD-10-CM code for unspecified intracapsular fracture of left femur, initial encounter for open fracture type iiia, iiib, or iiic. It is valid for submission on a claim.
7th character "C" — initial encounter for open fracture type IIIA, IIIB, or IIIC
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
S72.012C 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
S72.012C is named in 8 Medicare coverage policies — 8 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 S72.012. If S72.012C is not quite right, the correct code is usually one of these.
- S72.012AUnspecified intracapsular fracture of left femur, initial encounter for closed fracture
- S72.012BUnspecified intracapsular fracture of left femur, initial encounter for open fracture type I or II
- S72.012DUnspecified intracapsular fracture of left femur, subsequent encounter for closed fracture with routine healing
- S72.012EUnspecified intracapsular fracture of left femur, subsequent encounter for open fracture type I or II with routine healing
- S72.012FUnspecified intracapsular fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.012GUnspecified intracapsular fracture of left femur, subsequent encounter for closed fracture with delayed healing
- S72.012HUnspecified intracapsular fracture of left femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.012JUnspecified intracapsular fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.012KUnspecified intracapsular fracture of left femur, subsequent encounter for closed fracture with nonunion
- S72.012MUnspecified intracapsular fracture of left femur, subsequent encounter for open fracture type I or II with nonunion
- S72.012NUnspecified intracapsular fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.012PUnspecified intracapsular fracture of left femur, subsequent encounter for closed fracture with malunion
- S72.012QUnspecified intracapsular fracture of left femur, subsequent encounter for open fracture type I or II with malunion
- S72.012RUnspecified intracapsular fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.012SUnspecified intracapsular fracture of left femur, sequela
Questions about S72.012C
- Is S72.012C a billable ICD-10-CM code?
- Yes. S72.012C is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.012C 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).