S72.043A: Displaced fracture of base of neck of unspecified femur, initial encounter for closed fracture
S72.043A is a billable, specific ICD-10-CM code for displaced fracture of base of neck of unspecified femur, initial encounter for closed fracture. It is valid for submission on a claim.
Check S72.043A with the rest of the claim: free scrubber7th character "A": initial encounter for closed fracture
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 S72.043A
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S72.043A
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 S72.043A
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
S72.043A 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
S72.043A 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 S72.043
- S72.043BDisplaced fracture of base of neck of unspecified femur, initial encounter for open fracture type I or II
- S72.043CDisplaced fracture of base of neck of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.043DDisplaced fracture of base of neck of unspecified femur, subsequent encounter for closed fracture with routine healing
- S72.043EDisplaced fracture of base of neck of unspecified femur, subsequent encounter for open fracture type I or II with routine healing
- S72.043FDisplaced fracture of base of neck of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.043GDisplaced fracture of base of neck of unspecified femur, subsequent encounter for closed fracture with delayed healing
- S72.043HDisplaced fracture of base of neck of unspecified femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.043JDisplaced fracture of base of neck of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.043KDisplaced fracture of base of neck of unspecified femur, subsequent encounter for closed fracture with nonunion
- S72.043MDisplaced fracture of base of neck of unspecified femur, subsequent encounter for open fracture type I or II with nonunion
- S72.043NDisplaced fracture of base of neck of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.043PDisplaced fracture of base of neck of unspecified femur, subsequent encounter for closed fracture with malunion
- S72.043QDisplaced fracture of base of neck of unspecified femur, subsequent encounter for open fracture type I or II with malunion
- S72.043RDisplaced fracture of base of neck of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.043SDisplaced fracture of base of neck of unspecified femur, sequela