S72.43
S72.43 — Fracture of medial condyle of femur
Non-billable headerICD-10-CM
S72.43 is a non-billable header ICD-10-CM code for fracture of medial condyle of femur. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
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
S72.43 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.
Code to one of these instead S72.43
6 child codes. Green means billable.
- S72.431Displaced fracture of medial condyle of right femur
- S72.432Displaced fracture of medial condyle of left femur
- S72.433Displaced fracture of medial condyle of unspecified femur
- S72.434Nondisplaced fracture of medial condyle of right femur
- S72.435Nondisplaced fracture of medial condyle of left femur
- S72.436Nondisplaced fracture of medial condyle of unspecified femur
Related codes at this level
Codes that share S72.4. If S72.43 is not quite right, the correct code is usually one of these.
- S72.40Unspecified fracture of lower end of femur
- S72.41Unspecified condyle fracture of lower end of femur
- S72.42Fracture of lateral condyle of femur
- S72.44Fracture of lower epiphysis (separation) of femur
- S72.45Supracondylar fracture without intracondylar extension of lower end of femur
- S72.46Supracondylar fracture with intracondylar extension of lower end of femur
- S72.47Torus fracture of lower end of femur
- S72.49Other fracture of lower end of femur
Questions about S72.43
- Is S72.43 a billable ICD-10-CM code?
- No. S72.43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S72.43 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).