S72.059A: Unspecified fracture of head of unspecified femur, initial encounter for closed fracture
S72.059A is a billable, specific ICD-10-CM code for unspecified fracture of head of unspecified femur, initial encounter for closed fracture. It is valid for submission on a claim.
Check S72.059A 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 S72.059A
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S72.059A
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 S72.059A
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
S72.059A 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
S72.059A 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 S72.059
- S72.059BUnspecified fracture of head of unspecified femur, initial encounter for open fracture type I or II
- S72.059CUnspecified fracture of head of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.059DUnspecified fracture of head of unspecified femur, subsequent encounter for closed fracture with routine healing
- S72.059EUnspecified fracture of head of unspecified femur, subsequent encounter for open fracture type I or II with routine healing
- S72.059FUnspecified fracture of head of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.059GUnspecified fracture of head of unspecified femur, subsequent encounter for closed fracture with delayed healing
- S72.059HUnspecified fracture of head of unspecified femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.059JUnspecified fracture of head of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.059KUnspecified fracture of head of unspecified femur, subsequent encounter for closed fracture with nonunion
- S72.059MUnspecified fracture of head of unspecified femur, subsequent encounter for open fracture type I or II with nonunion
- S72.059NUnspecified fracture of head of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.059PUnspecified fracture of head of unspecified femur, subsequent encounter for closed fracture with malunion
- S72.059QUnspecified fracture of head of unspecified femur, subsequent encounter for open fracture type I or II with malunion
- S72.059RUnspecified fracture of head of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.059SUnspecified fracture of head of unspecified femur, sequela