S72.466C
S72.466C: Nondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
Billable / specific codeICD-10-CM
S72.466C is a billable, specific ICD-10-CM code for nondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, initial encounter for open fracture type iiia, iiib, or iiic. It is valid for submission on a claim.
Check S72.466C with the rest of the claim: free scrubber7th 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
Excludes1 inherited from the categories above S72.466C
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above S72.466C
Not part of this code, but both may be coded when both are present.
Written on S72.4: Fracture of lower end of femur
Other codes that can never be billed with S72.466C
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
S72.466C 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
S72.466C is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A57765Billing and Coding: Major Joint Replacement (Hip and Knee)
- A59811Billing and Coding: Total Joint Arthroplasty
- A60249Billing and Coding: Total Joint Arthroplasty
- A60250Billing and Coding: Total Joint Arthroplasty
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S72.466
- S72.466ANondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, initial encounter for closed fracture
- S72.466BNondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, initial encounter for open fracture type I or II
- S72.466DNondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, subsequent encounter for closed fracture with routine healing
- S72.466ENondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, subsequent encounter for open fracture type I or II with routine healing
- S72.466FNondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.466GNondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, subsequent encounter for closed fracture with delayed healing
- S72.466HNondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.466JNondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.466KNondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, subsequent encounter for closed fracture with nonunion
- S72.466MNondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, subsequent encounter for open fracture type I or II with nonunion
- S72.466NNondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.466PNondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, subsequent encounter for closed fracture with malunion
- S72.466QNondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, subsequent encounter for open fracture type I or II with malunion
- S72.466RNondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.466SNondisplaced supracondylar fracture with intracondylar extension of lower end of unspecified femur, sequela