S72.411J
S72.411J — Displaced unspecified condyle fracture of lower end of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
Billable / specific codeICD-10-CMPOA exemptright
S72.411J is a billable, specific ICD-10-CM code for displaced unspecified condyle fracture of lower end of right femur, subsequent encounter for open fracture type iiia, iiib, or iiic with delayed healing. It is valid for submission on a claim.
7th character "J" — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed 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
S72.411J 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
S72.411J is named in 5 Medicare coverage policies — 5 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
- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
Related codes at this level
Codes that share S72.411. If S72.411J is not quite right, the correct code is usually one of these.
- S72.411ADisplaced unspecified condyle fracture of lower end of right femur, initial encounter for closed fracture
- S72.411BDisplaced unspecified condyle fracture of lower end of right femur, initial encounter for open fracture type I or II
- S72.411CDisplaced unspecified condyle fracture of lower end of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.411DDisplaced unspecified condyle fracture of lower end of right femur, subsequent encounter for closed fracture with routine healing
- S72.411EDisplaced unspecified condyle fracture of lower end of right femur, subsequent encounter for open fracture type I or II with routine healing
- S72.411FDisplaced unspecified condyle fracture of lower end of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.411GDisplaced unspecified condyle fracture of lower end of right femur, subsequent encounter for closed fracture with delayed healing
- S72.411HDisplaced unspecified condyle fracture of lower end of right femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.411KDisplaced unspecified condyle fracture of lower end of right femur, subsequent encounter for closed fracture with nonunion
- S72.411MDisplaced unspecified condyle fracture of lower end of right femur, subsequent encounter for open fracture type I or II with nonunion
- S72.411NDisplaced unspecified condyle fracture of lower end of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.411PDisplaced unspecified condyle fracture of lower end of right femur, subsequent encounter for closed fracture with malunion
- S72.411QDisplaced unspecified condyle fracture of lower end of right femur, subsequent encounter for open fracture type I or II with malunion
- S72.411RDisplaced unspecified condyle fracture of lower end of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.411SDisplaced unspecified condyle fracture of lower end of right femur, sequela
Questions about S72.411J
- Is S72.411J a billable ICD-10-CM code?
- Yes. S72.411J is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.411J 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).