S72.091E
S72.091E — Other fracture of head and neck of right femur, subsequent encounter for open fracture type I or II with routine healing
Billable / specific codeICD-10-CMPOA exemptright
S72.091E is a billable, specific ICD-10-CM code for other fracture of head and neck of right femur, subsequent encounter for open fracture type i or ii with routine healing. It is valid for submission on a claim.
7th character "E" — subsequent encounter for open fracture type I or II with routine 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
S72.091E 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
S72.091E is named in 10 Medicare coverage policies — 10 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
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- A53065Billing and Coding: Outpatient Physical Therapy
Related codes at this level
Codes that share S72.091. If S72.091E 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
- S72.091BOther fracture of head and neck of right femur, initial encounter for open fracture type I or II
- 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
- S72.091FOther 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 S72.091E
- Is S72.091E a billable ICD-10-CM code?
- Yes. S72.091E is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.091E 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).