S72.355C
S72.355C — Nondisplaced comminuted fracture of shaft of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
Billable / specific codeICD-10-CMleft
S72.355C is a billable, specific ICD-10-CM code for nondisplaced comminuted fracture of shaft of left femur, initial encounter for open fracture type iiia, iiib, or iiic. It is valid for submission on a claim.
7th 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
Risk adjustment
S72.355C 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
S72.355C is named in 7 Medicare coverage policies — 7 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
- A56900Billing and Coding: Immunizations
Related codes at this level
Codes that share S72.355. If S72.355C is not quite right, the correct code is usually one of these.
- S72.355ANondisplaced comminuted fracture of shaft of left femur, initial encounter for closed fracture
- S72.355BNondisplaced comminuted fracture of shaft of left femur, initial encounter for open fracture type I or II
- S72.355DNondisplaced comminuted fracture of shaft of left femur, subsequent encounter for closed fracture with routine healing
- S72.355ENondisplaced comminuted fracture of shaft of left femur, subsequent encounter for open fracture type I or II with routine healing
- S72.355FNondisplaced comminuted fracture of shaft of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.355GNondisplaced comminuted fracture of shaft of left femur, subsequent encounter for closed fracture with delayed healing
- S72.355HNondisplaced comminuted fracture of shaft of left femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.355JNondisplaced comminuted fracture of shaft of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.355KNondisplaced comminuted fracture of shaft of left femur, subsequent encounter for closed fracture with nonunion
- S72.355MNondisplaced comminuted fracture of shaft of left femur, subsequent encounter for open fracture type I or II with nonunion
- S72.355NNondisplaced comminuted fracture of shaft of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.355PNondisplaced comminuted fracture of shaft of left femur, subsequent encounter for closed fracture with malunion
- S72.355QNondisplaced comminuted fracture of shaft of left femur, subsequent encounter for open fracture type I or II with malunion
- S72.355RNondisplaced comminuted fracture of shaft of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.355SNondisplaced comminuted fracture of shaft of left femur, sequela
Questions about S72.355C
- Is S72.355C a billable ICD-10-CM code?
- Yes. S72.355C is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.355C 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).