S72.434A
S72.434A — Nondisplaced fracture of medial condyle of right femur, initial encounter for closed fracture
Billable / specific codeICD-10-CMright
S72.434A is a billable, specific ICD-10-CM code for nondisplaced fracture of medial condyle of right 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
Risk adjustment
S72.434A 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.
Medicare coverage
S72.434A is named in 5 Medicare coverage policies — 5 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
- A56777Billing and Coding: Total Joint Arthroplasty
- A57311Billing and Coding: Physical Therapy - Home Health
Related codes at this level
Codes that share S72.434. If S72.434A is not quite right, the correct code is usually one of these.
- S72.434BNondisplaced fracture of medial condyle of right femur, initial encounter for open fracture type I or II
- S72.434CNondisplaced fracture of medial condyle of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.434DNondisplaced fracture of medial condyle of right femur, subsequent encounter for closed fracture with routine healing
- S72.434ENondisplaced fracture of medial condyle of right femur, subsequent encounter for open fracture type I or II with routine healing
- S72.434FNondisplaced fracture of medial condyle of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.434GNondisplaced fracture of medial condyle of right femur, subsequent encounter for closed fracture with delayed healing
- S72.434HNondisplaced fracture of medial condyle of right femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.434JNondisplaced fracture of medial condyle of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.434KNondisplaced fracture of medial condyle of right femur, subsequent encounter for closed fracture with nonunion
- S72.434MNondisplaced fracture of medial condyle of right femur, subsequent encounter for open fracture type I or II with nonunion
- S72.434NNondisplaced fracture of medial condyle of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.434PNondisplaced fracture of medial condyle of right femur, subsequent encounter for closed fracture with malunion
- S72.434QNondisplaced fracture of medial condyle of right femur, subsequent encounter for open fracture type I or II with malunion
- S72.434RNondisplaced fracture of medial condyle of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.434SNondisplaced fracture of medial condyle of right femur, sequela
Questions about S72.434A
- Is S72.434A a billable ICD-10-CM code?
- Yes. S72.434A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.434A 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).