S72.091B — Other fracture of head and neck of right femur, initial encounter for open fracture type I or II
S72.091B is a billable, specific ICD-10-CM code for other fracture of head and neck of right femur, initial encounter for open fracture type i or ii. It is valid for submission on a claim.
7th character "B" — initial encounter for open fracture type I or II
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 S72.091B
These are not written on S72.091B, but they bind it: a note on a category applies to every code beneath it. Billing S72.091B with anything listed here is a denial.
Excludes2 inherited from the categories above S72.091B
Also inherited, and the opposite of Excludes1: these conditions are not part of S72.091B, 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 S72.091B
These codes carry an Excludes1 note pointing at S72.091B. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S72.091B alone.
Risk adjustment
S72.091B 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.
Medicare coverage
S72.091B is named in 12 Medicare coverage policies — 12 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
- A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
- A56421Billing and Coding: CT of the Abdomen and Pelvis
Code history
S72.091B 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 S72.091. If S72.091B is not quite right, the correct code is usually one of these.
- S72.091AOther fracture of head and neck of right femur, initial encounter for closed fracture
- S72.091COther fracture of head and neck of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.091DOther fracture of head and neck of right femur, subsequent encounter for closed fracture with routine healing
- S72.091EOther fracture of head and neck of right femur, subsequent encounter for open fracture type I or II with routine healing
- S72.091FOther fracture of head and neck of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.091GOther fracture of head and neck of right femur, subsequent encounter for closed fracture with delayed healing
- S72.091HOther fracture of head and neck of right femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.091JOther fracture of head and neck of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.091KOther fracture of head and neck of right femur, subsequent encounter for closed fracture with nonunion
- S72.091MOther fracture of head and neck of right femur, subsequent encounter for open fracture type I or II with nonunion
- S72.091NOther fracture of head and neck of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.091POther fracture of head and neck of right femur, subsequent encounter for closed fracture with malunion
- S72.091QOther fracture of head and neck of right femur, subsequent encounter for open fracture type I or II with malunion
- S72.091ROther fracture of head and neck of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.091SOther fracture of head and neck of right femur, sequela
Questions about S72.091B
- Is S72.091B a billable ICD-10-CM code?
- Yes. S72.091B is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.091B 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 S72.091B?
- S72.091B 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 S72.091B (S72) and apply to it just the same.