S72.492E
S72.492E — Other fracture of lower end of left femur, subsequent encounter for open fracture type I or II with routine healing
Billable / specific codeICD-10-CMPOA exemptleft
S72.492E is a billable, specific ICD-10-CM code for other fracture of lower end of left femur, subsequent encounter for open fracture type i or ii with routine healing. It is valid for submission on a claim.
7th character "E" — subsequent encounter for open fracture type I or II with routine healing
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
S72.492E 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
S72.492E 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
- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
Related codes at this level
Codes that share S72.492. If S72.492E is not quite right, the correct code is usually one of these.
- S72.492AOther fracture of lower end of left femur, initial encounter for closed fracture
- S72.492BOther fracture of lower end of left femur, initial encounter for open fracture type I or II
- S72.492COther fracture of lower end of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.492DOther fracture of lower end of left femur, subsequent encounter for closed fracture with routine healing
- S72.492FOther fracture of lower end of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.492GOther fracture of lower end of left femur, subsequent encounter for closed fracture with delayed healing
- S72.492HOther fracture of lower end of left femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.492JOther fracture of lower end of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.492KOther fracture of lower end of left femur, subsequent encounter for closed fracture with nonunion
- S72.492MOther fracture of lower end of left femur, subsequent encounter for open fracture type I or II with nonunion
- S72.492NOther fracture of lower end of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S72.492POther fracture of lower end of left femur, subsequent encounter for closed fracture with malunion
- S72.492QOther fracture of lower end of left femur, subsequent encounter for open fracture type I or II with malunion
- S72.492ROther fracture of lower end of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S72.492SOther fracture of lower end of left femur, sequela
Questions about S72.492E
- Is S72.492E a billable ICD-10-CM code?
- Yes. S72.492E is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S72.492E 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).