S72.401B
S72.401B — Unspecified fracture of lower end of right femur, initial encounter for open fracture type I or II
Billable / specific codeICD-10-CMright
S72.401B is a billable, specific ICD-10-CM code for unspecified fracture of lower end 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
Risk adjustment
S72.401B 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
S72.401B is named in 4 Medicare coverage policies — 4 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
- A57685Billing and Coding: Total Knee Arthroplasty
Related codes at this level
Codes that share S72.401. If S72.401B is not quite right, the correct code is usually one of these.
- S72.401AUnspecified fracture of lower end of right femur, initial encounter for closed fracture
- S72.401CUnspecified fracture of lower end of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.401DUnspecified fracture of lower end of right femur, subsequent encounter for closed fracture with routine healing
- S72.401EUnspecified fracture of lower end of right femur, subsequent encounter for open fracture type I or II with routine healing
- S72.401FUnspecified fracture of lower end of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.401GUnspecified fracture of lower end of right femur, subsequent encounter for closed fracture with delayed healing
- S72.401HUnspecified fracture of lower end of right femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.401JUnspecified fracture of lower end of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.401KUnspecified fracture of lower end of right femur, subsequent encounter for closed fracture with nonunion
- S72.401MUnspecified fracture of lower end of right femur, subsequent encounter for open fracture type I or II with nonunion
- S72.401NUnspecified fracture of lower end of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.401PUnspecified fracture of lower end of right femur, subsequent encounter for closed fracture with malunion
- S72.401QUnspecified fracture of lower end of right femur, subsequent encounter for open fracture type I or II with malunion
- S72.401RUnspecified fracture of lower end of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.401SUnspecified fracture of lower end of right femur, sequela
Questions about S72.401B
- Is S72.401B a billable ICD-10-CM code?
- Yes. S72.401B is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.401B 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).