S72.426A — Nondisplaced fracture of lateral condyle of unspecified femur, initial encounter for closed fracture
S72.426A is a billable, specific ICD-10-CM code for nondisplaced fracture of lateral condyle of unspecified femur, initial encounter for closed fracture. It is valid for submission on a claim.
7th 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 S72.426A
These are not written on S72.426A, but they bind it: a note on a category applies to every code beneath it. Billing S72.426A with anything listed here is a denial.
Excludes2 inherited from the categories above S72.426A
Also inherited, and the opposite of Excludes1: these conditions are not part of S72.426A, 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 S72.426A
These codes carry an Excludes1 note pointing at S72.426A. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S72.426A alone.
Risk adjustment
S72.426A 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.
Code history
S72.426A 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 S72.426. If S72.426A is not quite right, the correct code is usually one of these.
- S72.426BNondisplaced fracture of lateral condyle of unspecified femur, initial encounter for open fracture type I or II
- S72.426CNondisplaced fracture of lateral condyle of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.426DNondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for closed fracture with routine healing
- S72.426ENondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for open fracture type I or II with routine healing
- S72.426FNondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.426GNondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for closed fracture with delayed healing
- S72.426HNondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.426JNondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.426KNondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for closed fracture with nonunion
- S72.426MNondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for open fracture type I or II with nonunion
- S72.426NNondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.426PNondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for closed fracture with malunion
- S72.426QNondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for open fracture type I or II with malunion
- S72.426RNondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.426SNondisplaced fracture of lateral condyle of unspecified femur, sequela
Questions about S72.426A
- Is S72.426A a billable ICD-10-CM code?
- Yes. S72.426A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.426A 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 S72.426A?
- S72.426A 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 S72.426A (S72) and apply to it just the same.