Is S72.499B a billable ICD-10-CM code?

Yes. S72.499B is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S72.499B 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).

S72.499B

S72.499B — Other fracture of lower end of unspecified femur, initial encounter for open fracture type I or II

Billable / specific codeICD-10-CM

S72.499B is a billable, specific ICD-10-CM code for other fracture of lower end of unspecified femur, initial encounter for open fracture type i or ii. It is valid for submission on a claim.

7th character "B" — initial encounter for open fracture type I or II

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

S72.499B 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.

Related codes at this level

Codes that share S72.499. If S72.499B is not quite right, the correct code is usually one of these.

Questions about S72.499B

Is S72.499B a billable ICD-10-CM code?: Yes. S72.499B is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S72.499B 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).