Is S72.491 a billable ICD-10-CM code?

No. S72.491 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does S72.491 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).

S72.491

S72.491 — Other fracture of lower end of right femur

Non-billable headerICD-10-CMright

S72.491 is a non-billable header ICD-10-CM code for other fracture of lower end of right femur. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

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

S72.491 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.

Code to one of these instead S72.491

16 child codes. Green means billable.

Related codes at this level

Codes that share S72.49. If S72.491 is not quite right, the correct code is usually one of these.

Questions about S72.491

Is S72.491 a billable ICD-10-CM code?: No. S72.491 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does S72.491 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).