S72.454C
S72.454C — Nondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
Billable / specific codeICD-10-CMright
S72.454C is a billable, specific ICD-10-CM code for nondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, initial encounter for open fracture type iiia, iiib, or iiic. It is valid for submission on a claim.
7th character "C" — initial encounter for open fracture type IIIA, IIIB, or IIIC
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
S72.454C 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
S72.454C 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
- A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
- A56900Billing and Coding: Immunizations
Related codes at this level
Codes that share S72.454. If S72.454C is not quite right, the correct code is usually one of these.
- S72.454ANondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, initial encounter for closed fracture
- S72.454BNondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, initial encounter for open fracture type I or II
- S72.454DNondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, subsequent encounter for closed fracture with routine healing
- S72.454ENondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, subsequent encounter for open fracture type I or II with routine healing
- S72.454FNondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.454GNondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, subsequent encounter for closed fracture with delayed healing
- S72.454HNondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.454JNondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.454KNondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, subsequent encounter for closed fracture with nonunion
- S72.454MNondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, subsequent encounter for open fracture type I or II with nonunion
- S72.454NNondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.454PNondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, subsequent encounter for closed fracture with malunion
- S72.454QNondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, subsequent encounter for open fracture type I or II with malunion
- S72.454RNondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.454SNondisplaced supracondylar fracture without intracondylar extension of lower end of right femur, sequela
Questions about S72.454C
- Is S72.454C a billable ICD-10-CM code?
- Yes. S72.454C is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.454C 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).