S72.412A: Displaced unspecified condyle fracture of lower end of left femur, initial encounter for closed fracture
S72.412A is a billable, specific ICD-10-CM code for displaced unspecified condyle fracture of lower end of left femur, initial encounter for closed fracture. It is valid for submission on a claim.
Check S72.412A with the rest of the claim: free scrubber7th character "A": initial encounter for closed fracture
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 S72.412A
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S72.412A
Not part of this code, but both may be coded when both are present.
Written on S72.4: Fracture of lower end of femur
Other codes that can never be billed with S72.412A
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
S72.412A 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
S72.412A is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52465Knee Orthoses - Policy Article
- A56777Billing and Coding: Total Joint Arthroplasty
- A57685Billing and Coding: Total Knee Arthroplasty
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S72.412
- S72.412BDisplaced unspecified condyle fracture of lower end of left femur, initial encounter for open fracture type I or II
- S72.412CDisplaced unspecified condyle fracture of lower end of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.412DDisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for closed fracture with routine healing
- S72.412EDisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for open fracture type I or II with routine healing
- S72.412FDisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.412GDisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for closed fracture with delayed healing
- S72.412HDisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.412JDisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.412KDisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for closed fracture with nonunion
- S72.412MDisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for open fracture type I or II with nonunion
- S72.412NDisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.412PDisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for closed fracture with malunion
- S72.412QDisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for open fracture type I or II with malunion
- S72.412RDisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.412SDisplaced unspecified condyle fracture of lower end of left femur, sequela