S72.126C: Nondisplaced fracture of lesser trochanter of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
S72.126C is a billable, specific ICD-10-CM code for nondisplaced fracture of lesser trochanter of unspecified femur, initial encounter for open fracture type iiia, iiib, or iiic. It is valid for submission on a claim.
Check S72.126C with the rest of the claim: free scrubber7th character "C": initial encounter for open fracture type IIIA, IIIB, or IIIC
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 S72.126C
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S72.126C
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with S72.126C
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
S72.126C 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
S72.126C 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 S72.126
- S72.126ANondisplaced fracture of lesser trochanter of unspecified femur, initial encounter for closed fracture
- S72.126BNondisplaced fracture of lesser trochanter of unspecified femur, initial encounter for open fracture type I or II
- S72.126DNondisplaced fracture of lesser trochanter of unspecified femur, subsequent encounter for closed fracture with routine healing
- S72.126ENondisplaced fracture of lesser trochanter of unspecified femur, subsequent encounter for open fracture type I or II with routine healing
- S72.126FNondisplaced fracture of lesser trochanter of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.126GNondisplaced fracture of lesser trochanter of unspecified femur, subsequent encounter for closed fracture with delayed healing
- S72.126HNondisplaced fracture of lesser trochanter of unspecified femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.126JNondisplaced fracture of lesser trochanter of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.126KNondisplaced fracture of lesser trochanter of unspecified femur, subsequent encounter for closed fracture with nonunion
- S72.126MNondisplaced fracture of lesser trochanter of unspecified femur, subsequent encounter for open fracture type I or II with nonunion
- S72.126NNondisplaced fracture of lesser trochanter of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.126PNondisplaced fracture of lesser trochanter of unspecified femur, subsequent encounter for closed fracture with malunion
- S72.126QNondisplaced fracture of lesser trochanter of unspecified femur, subsequent encounter for open fracture type I or II with malunion
- S72.126RNondisplaced fracture of lesser trochanter of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.126SNondisplaced fracture of lesser trochanter of unspecified femur, sequela