Is S72.019K a billable ICD-10-CM code?

Yes. S72.019K is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S72.019K 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).

S72.019K

S72.019K — Unspecified intracapsular fracture of unspecified femur, subsequent encounter for closed fracture with nonunion

Billable / specific codeICD-10-CMPOA exempt

S72.019K is a billable, specific ICD-10-CM code for unspecified intracapsular fracture of unspecified femur, subsequent encounter for closed fracture with nonunion. It is valid for submission on a claim.

7th character "K" — subsequent encounter for closed fracture with nonunion

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

S72.019K 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.

Medicare coverage

S72.019K is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57765Billing and Coding: Major Joint Replacement (Hip and Knee)

Related codes at this level

Codes that share S72.019. If S72.019K is not quite right, the correct code is usually one of these.

Questions about S72.019K

Is S72.019K a billable ICD-10-CM code?: Yes. S72.019K is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S72.019K 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).