S72.043M
S72.043M — Displaced fracture of base of neck of unspecified femur, subsequent encounter for open fracture type I or II with nonunion
Billable / specific codeICD-10-CMPOA exempt
S72.043M is a billable, specific ICD-10-CM code for displaced fracture of base of neck of unspecified femur, subsequent encounter for open fracture type i or ii with nonunion. It is valid for submission on a claim.
7th character "M" — subsequent encounter for open fracture type I or II 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
S72.043M 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
S72.043M 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 S72.043. If S72.043M is not quite right, the correct code is usually one of these.
- S72.043ADisplaced fracture of base of neck of unspecified femur, initial encounter for closed fracture
- 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
- S72.043NDisplaced 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
Questions about S72.043M
- Is S72.043M a billable ICD-10-CM code?
- Yes. S72.043M is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.043M 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).