S72.022J — Displaced fracture of epiphysis (separation) (upper) of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
S72.022J is a billable, specific ICD-10-CM code for displaced fracture of epiphysis (separation) (upper) of left femur, subsequent encounter for open fracture type iiia, iiib, or iiic with delayed healing. It is valid for submission on a claim.
7th character "J" — subsequent encounter for open fracture type IIIA, IIIB, or IIIC 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 S72.022J
These are not written on S72.022J, but they bind it: a note on a category applies to every code beneath it. Billing S72.022J with anything listed here is a denial.
Written on S72.02 — Fracture of epiphysis (separation) (upper) of femur
Excludes2 inherited from the categories above S72.022J
Also inherited, and the opposite of Excludes1: these conditions are not part of S72.022J, but a patient can have both, so you may code both.
Written on S72.0 — Fracture of head and neck of femur
Other codes that can never be billed with S72.022J
These codes carry an Excludes1 note pointing at S72.022J. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S72.022J alone.
Risk adjustment
S72.022J 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
S72.022J is named in 13 Medicare coverage policies — 13 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
- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
Code history
S72.022J has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share S72.022. If S72.022J is not quite right, the correct code is usually one of these.
- S72.022ADisplaced fracture of epiphysis (separation) (upper) of left femur, initial encounter for closed fracture
- S72.022BDisplaced fracture of epiphysis (separation) (upper) of left femur, initial encounter for open fracture type I or II
- S72.022CDisplaced fracture of epiphysis (separation) (upper) of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.022DDisplaced fracture of epiphysis (separation) (upper) of left femur, subsequent encounter for closed fracture with routine healing
- S72.022EDisplaced fracture of epiphysis (separation) (upper) of left femur, subsequent encounter for open fracture type I or II with routine healing
- S72.022FDisplaced fracture of epiphysis (separation) (upper) of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.022GDisplaced fracture of epiphysis (separation) (upper) of left femur, subsequent encounter for closed fracture with delayed healing
- S72.022HDisplaced fracture of epiphysis (separation) (upper) of left femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.022KDisplaced fracture of epiphysis (separation) (upper) of left femur, subsequent encounter for closed fracture with nonunion
- S72.022MDisplaced fracture of epiphysis (separation) (upper) of left femur, subsequent encounter for open fracture type I or II with nonunion
- S72.022NDisplaced fracture of epiphysis (separation) (upper) of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.022PDisplaced fracture of epiphysis (separation) (upper) of left femur, subsequent encounter for closed fracture with malunion
- S72.022QDisplaced fracture of epiphysis (separation) (upper) of left femur, subsequent encounter for open fracture type I or II with malunion
- S72.022RDisplaced fracture of epiphysis (separation) (upper) of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.022SDisplaced fracture of epiphysis (separation) (upper) of left femur, sequela
Questions about S72.022J
- Is S72.022J a billable ICD-10-CM code?
- Yes. S72.022J is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.022J 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).
- What cannot be coded together with S72.022J?
- S72.022J carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S72.022J (S72.02, S72) and apply to it just the same.