S72.435S
S72.435S — Nondisplaced fracture of medial condyle of left femur, sequela
Billable / specific codeICD-10-CMPOA exemptleft
S72.435S is a billable, specific ICD-10-CM code for nondisplaced fracture of medial condyle of left femur, sequela. It is valid for submission on a claim.
7th character "S" — sequela
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
S72.435S 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
S72.435S is named in 8 Medicare coverage policies — 8 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
- A53057Billing and Coding: Home Health Occupational Therapy
- A53058Billing and Coding: Home Health Physical Therapy
Related codes at this level
Codes that share S72.435. If S72.435S is not quite right, the correct code is usually one of these.
- S72.435ANondisplaced fracture of medial condyle of left femur, initial encounter for closed fracture
- S72.435BNondisplaced fracture of medial condyle of left femur, initial encounter for open fracture type I or II
- S72.435CNondisplaced fracture of medial condyle of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.435DNondisplaced fracture of medial condyle of left femur, subsequent encounter for closed fracture with routine healing
- S72.435ENondisplaced fracture of medial condyle of left femur, subsequent encounter for open fracture type I or II with routine healing
- S72.435FNondisplaced fracture of medial condyle of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.435GNondisplaced fracture of medial condyle of left femur, subsequent encounter for closed fracture with delayed healing
- S72.435HNondisplaced fracture of medial condyle of left femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.435JNondisplaced fracture of medial condyle of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.435KNondisplaced fracture of medial condyle of left femur, subsequent encounter for closed fracture with nonunion
- S72.435MNondisplaced fracture of medial condyle of left femur, subsequent encounter for open fracture type I or II with nonunion
- S72.435NNondisplaced fracture of medial condyle of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.435PNondisplaced fracture of medial condyle of left femur, subsequent encounter for closed fracture with malunion
- S72.435QNondisplaced fracture of medial condyle of left femur, subsequent encounter for open fracture type I or II with malunion
- S72.435RNondisplaced fracture of medial condyle of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
Questions about S72.435S
- Is S72.435S a billable ICD-10-CM code?
- Yes. S72.435S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.435S 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).