S72.472A — Torus fracture of lower end of left femur, initial encounter for closed fracture
S72.472A is a billable, specific ICD-10-CM code for torus fracture of lower end of left 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 in subcategory S72.47
- A
- initial encounter for closed fracture
- D
- subsequent encounter for fracture with routine healing
- G
- subsequent encounter for fracture with delayed healing
- K
- subsequent encounter for fracture with nonunion
- P
- subsequent encounter for fracture with malunion
- S
- sequela
Risk adjustment
S72.472A 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
S72.472A 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 S72.472. If S72.472A is not quite right, the correct code is usually one of these.
- S72.472DTorus fracture of lower end of left femur, subsequent encounter for fracture with routine healing
- S72.472GTorus fracture of lower end of left femur, subsequent encounter for fracture with delayed healing
- S72.472KTorus fracture of lower end of left femur, subsequent encounter for fracture with nonunion
- S72.472PTorus fracture of lower end of left femur, subsequent encounter for fracture with malunion
- S72.472STorus fracture of lower end of left femur, sequela
Questions about S72.472A
- Is S72.472A a billable ICD-10-CM code?
- Yes. S72.472A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.472A 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).