Is S79.001A a billable ICD-10-CM code?

Yes. S79.001A is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S79.001A 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).

What cannot be coded together with S79.001A?

S79.001A carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S79.001A (S79.0) and apply to it just the same.

S79.001A

S79.001A — Unspecified physeal fracture of upper end of right femur, initial encounter for closed fracture

Billable / specific codeICD-10-CMright

S79.001A is a billable, specific ICD-10-CM code for unspecified physeal fracture of upper end of right 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 each code from subcategories S79.0 and S79.1

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

Excludes1 inherited from the categories above S79.001A

These are not written on S79.001A, but they bind it: a note on a category applies to every code beneath it. Billing S79.001A with anything listed here is a denial.

Written on S79.0 — Physeal fracture of upper end of femur

apophyseal fracture of upper end of femur (S72.13-)
nontraumatic slipped upper femoral epiphysis (M93.0-)

Risk adjustment

S79.001A 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

S79.001A is named in 7 Medicare coverage policies — 7 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
A56796Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)

Code history

S79.001A has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share S79.001. If S79.001A is not quite right, the correct code is usually one of these.

Questions about S79.001A

Is S79.001A a billable ICD-10-CM code?: Yes. S79.001A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S79.001A 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).
What cannot be coded together with S79.001A?: S79.001A carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S79.001A (S79.0) and apply to it just the same.