S72.421H — Displaced fracture of lateral condyle of right femur, subsequent encounter for open fracture type I or II with delayed healing
S72.421H is a billable, specific ICD-10-CM code for displaced fracture of lateral condyle of right femur, subsequent encounter for open fracture type i or ii with delayed healing. It is valid for submission on a claim.
7th character "H" — subsequent encounter for open fracture type I or II 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
Excludes1 inherited from the categories above S72.421H
These are not written on S72.421H, but they bind it: a note on a category applies to every code beneath it. Billing S72.421H with anything listed here is a denial.
Excludes2 inherited from the categories above S72.421H
Also inherited, and the opposite of Excludes1: these conditions are not part of S72.421H, but a patient can have both, so you may code both.
Written on S72.4 — Fracture of lower end of femur
Other codes that can never be billed with S72.421H
These codes carry an Excludes1 note pointing at S72.421H. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S72.421H alone.
Risk adjustment
S72.421H 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
S72.421H is named in 6 Medicare coverage policies — 6 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
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- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
Code history
S72.421H has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share S72.421. If S72.421H is not quite right, the correct code is usually one of these.
- S72.421ADisplaced fracture of lateral condyle of right femur, initial encounter for closed fracture
- S72.421BDisplaced fracture of lateral condyle of right femur, initial encounter for open fracture type I or II
- S72.421CDisplaced fracture of lateral condyle of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.421DDisplaced fracture of lateral condyle of right femur, subsequent encounter for closed fracture with routine healing
- S72.421EDisplaced fracture of lateral condyle of right femur, subsequent encounter for open fracture type I or II with routine healing
- S72.421FDisplaced fracture of lateral condyle of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.421GDisplaced fracture of lateral condyle of right femur, subsequent encounter for closed fracture with delayed healing
- S72.421JDisplaced fracture of lateral condyle of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.421KDisplaced fracture of lateral condyle of right femur, subsequent encounter for closed fracture with nonunion
- S72.421MDisplaced fracture of lateral condyle of right femur, subsequent encounter for open fracture type I or II with nonunion
- S72.421NDisplaced fracture of lateral condyle of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.421PDisplaced fracture of lateral condyle of right femur, subsequent encounter for closed fracture with malunion
- S72.421QDisplaced fracture of lateral condyle of right femur, subsequent encounter for open fracture type I or II with malunion
- S72.421RDisplaced fracture of lateral condyle of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.421SDisplaced fracture of lateral condyle of right femur, sequela
Questions about S72.421H
- Is S72.421H a billable ICD-10-CM code?
- Yes. S72.421H is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.421H 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).
- What cannot be coded together with S72.421H?
- S72.421H carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S72.421H (S72) and apply to it just the same.