S72.019B: Unspecified intracapsular fracture of unspecified femur, initial encounter for open fracture type I or II
S72.019B is a billable, specific ICD-10-CM code for unspecified intracapsular fracture of unspecified femur, initial encounter for open fracture type i or ii. It is valid for submission on a claim.
Check S72.019B with the rest of the claim: free scrubber7th 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
Excludes1 inherited from the categories above S72.019B
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S72.019B
Not part of this code, but both may be coded when both are present.
Written on S72.0: Fracture of head and neck of femur
Other codes that can never be billed with S72.019B
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
S72.019B 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
S72.019B is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A57765Billing and Coding: Major Joint Replacement (Hip and Knee)
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S72.019
- S72.019AUnspecified intracapsular fracture of unspecified femur, initial encounter for closed fracture
- S72.019CUnspecified intracapsular fracture of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.019DUnspecified intracapsular fracture of unspecified femur, subsequent encounter for closed fracture with routine healing
- S72.019EUnspecified intracapsular fracture of unspecified femur, subsequent encounter for open fracture type I or II with routine healing
- S72.019FUnspecified intracapsular fracture of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.019GUnspecified intracapsular fracture of unspecified femur, subsequent encounter for closed fracture with delayed healing
- S72.019HUnspecified intracapsular fracture of unspecified femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.019JUnspecified intracapsular fracture of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.019KUnspecified intracapsular fracture of unspecified femur, subsequent encounter for closed fracture with nonunion
- S72.019MUnspecified intracapsular fracture of unspecified femur, subsequent encounter for open fracture type I or II with nonunion
- S72.019NUnspecified intracapsular fracture of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.019PUnspecified intracapsular fracture of unspecified femur, subsequent encounter for closed fracture with malunion
- S72.019QUnspecified intracapsular fracture of unspecified femur, subsequent encounter for open fracture type I or II with malunion
- S72.019RUnspecified intracapsular fracture of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.019SUnspecified intracapsular fracture of unspecified femur, sequela