S72.021H

S72.021H: Displaced fracture of epiphysis (separation) (upper) of right femur, subsequent encounter for open fracture type I or II with delayed healing

Billable / specific codeICD-10-CMPOA exemptright

S72.021H is a billable, specific ICD-10-CM code for displaced fracture of epiphysis (separation) (upper) of right femur, subsequent encounter for open fracture type i or ii with delayed healing. It is valid for submission on a claim.

Check S72.021H with the rest of the claim: free scrubber

7th character "H": subsequent encounter for open fracture type I or II with delayed healing

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 S72.021H

A category’s note binds every code beneath it.

Written on S72.02: Fracture of epiphysis (separation) (upper) of femur

capital femoral epiphyseal fracture (pediatric) of femur (S79.01-)
Salter-Harris Type I physeal fracture of upper end of femur (S79.01-)

Written on S72: Fracture of femur

traumatic amputation of hip and thigh (S78.-)

Excludes2 inherited from the categories above S72.021H

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

physeal fracture of lower end of femur (S79.1-)
physeal fracture of upper end of femur (S79.0-)

Written on S72: Fracture of femur

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

Other codes that can never be billed with S72.021H

Their own Excludes1 notes name this code, so the conflict is not listed above.

M84.3Stress fracture
M84.4Pathological fracture, not elsewhere classified
S71Open wound of hip and thigh

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

S72.021H is named in 12 Medicare coverage policies: 12 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52465Knee Orthoses - Policy Article
A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy
A56421Billing and Coding: CT of the Abdomen and Pelvis

Code history

Unchanged in every release from FY2024 to FY2027.