S79.192A — Other physeal fracture of lower end of left femur, initial encounter for closed fracture
S79.192A is a billable, specific ICD-10-CM code for other physeal 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 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
Risk adjustment
S79.192A 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
S79.192A is named in 4 Medicare coverage policies — 4 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
- A57685Billing and Coding: Total Knee Arthroplasty
Related codes at this level
Codes that share S79.192. If S79.192A is not quite right, the correct code is usually one of these.
- S79.192DOther physeal fracture of lower end of left femur, subsequent encounter for fracture with routine healing
- S79.192GOther physeal fracture of lower end of left femur, subsequent encounter for fracture with delayed healing
- S79.192KOther physeal fracture of lower end of left femur, subsequent encounter for fracture with nonunion
- S79.192POther physeal fracture of lower end of left femur, subsequent encounter for fracture with malunion
- S79.192SOther physeal fracture of lower end of left femur, sequela
Questions about S79.192A
- Is S79.192A a billable ICD-10-CM code?
- Yes. S79.192A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S79.192A 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).