S72.026H
S72.026H — Nondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, subsequent encounter for open fracture type I or II with delayed healing
Billable / specific codeICD-10-CMPOA exempt
S72.026H is a billable, specific ICD-10-CM code for nondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, subsequent encounter for open fracture type i or ii with delayed healing. It is valid for submission on a claim.
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
Risk adjustment
S72.026H 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
S72.026H 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 S72.026. If S72.026H is not quite right, the correct code is usually one of these.
- S72.026ANondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, initial encounter for closed fracture
- S72.026BNondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, initial encounter for open fracture type I or II
- S72.026CNondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.026DNondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, subsequent encounter for closed fracture with routine healing
- S72.026ENondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, subsequent encounter for open fracture type I or II with routine healing
- S72.026FNondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.026GNondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, subsequent encounter for closed fracture with delayed healing
- S72.026JNondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.026KNondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, subsequent encounter for closed fracture with nonunion
- S72.026MNondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, subsequent encounter for open fracture type I or II with nonunion
- S72.026NNondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.026PNondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, subsequent encounter for closed fracture with malunion
- S72.026QNondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, subsequent encounter for open fracture type I or II with malunion
- S72.026RNondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.026SNondisplaced fracture of epiphysis (separation) (upper) of unspecified femur, sequela
Questions about S72.026H
- Is S72.026H a billable ICD-10-CM code?
- Yes. S72.026H is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.026H 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).