S72.421J
S72.421J — Displaced fracture of lateral condyle of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
Billable / specific codeICD-10-CMPOA exemptright
S72.421J is a billable, specific ICD-10-CM code for displaced fracture of lateral condyle 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
S72.421J 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
S72.421J 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
- 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 S72.421. If S72.421J 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
- S72.421HDisplaced fracture of lateral condyle of right femur, subsequent encounter for open fracture type I or II 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 S72.421J
- Is S72.421J a billable ICD-10-CM code?
- Yes. S72.421J is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.421J 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).