ICD-10 Coding for Fracture of Femur(S72.001D, S72.21XA)
Complete ICD-10-CM coding and documentation guide for Fracture of Femur. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Fracture of Femur
S72.0-S72.9Primary Range
Fractures of femur
This range includes all types of femoral fractures, including neck, shaft, and distal femur fractures.
Periprosthetic fractures around internal prosthetic joint
Used for fractures occurring around prosthetic joints, often in conjunction with femur fracture codes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S72.001D | Fracture of neck of right femur, subsequent encounter for fracture with routine healing | Use for follow-up visits when the fracture is healing as expected without complications. |
|
| S72.21XA | Displaced subtrochanteric fracture of right femur, initial encounter for closed fracture | Use for initial treatment of a traumatic subtrochanteric fracture. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for femur fracture
Essential facts and insights about Fracture of Femur
Primary ICD-10-CM Codes for fracture of femur
Decision Criteria
clinical Criteria
- Fracture healing confirmed by imaging
documentation Criteria
- Follow-up visit for routine healing
Applicable To
- Closed fracture of neck of femur
Excludes
- Pathological fracture (M84.4-)
Clinical Validation Requirements
- Documented evidence of fracture healing on follow-up X-ray
- Patient history indicating initial fracture treatment
Code-Specific Risks
- Omitting the 7th character indicating the encounter type
Coding Notes
- Ensure documentation specifies the type of encounter (initial, subsequent, sequela) using the appropriate 7th character.
S72.21XA - Displaced subtrochanteric fracture of right femur, initial encounter for closed fracture
Use for initial treatment of a traumatic subtrochanteric fracture.
Applicable To
- Closed subtrochanteric fracture
Excludes
- Open fracture (S72.22-)
Clinical Validation Requirements
- Initial X-ray or CT scan confirming fracture location and type
- Clinical notes detailing mechanism of injury
Coding Notes
Ensure proper documentation of fracture type and location to avoid coding errors.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Periprosthetic fracture around internal prosthetic right hip joint, initial encounter
M97.01XADifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Fracture of Femur to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S72.001D.
Impact
Clinical: Can lead to incorrect treatment of the wrong limb., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Always document right or left side in clinical notes., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect coding can lead to claim denials or reduced reimbursement., Compliance: May result in non-compliance with coding guidelines., Data Quality: Affects accuracy of medical records and data reporting.
Mitigation Strategy
Use M97.01XA for fractures around prosthetic joints unless there's a mechanical complication.
Impact
Incomplete documentation of fracture details can lead to audit failures.
Mitigation Strategy
Implement thorough documentation practices and regular audits.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Fracture of Femur, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Fracture of Femur
Use these documentation templates to ensure complete and accurate documentation for Fracture of Femur. These templates include all required elements for proper coding and billing.
Initial encounter for open subtrochanteric fracture
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Fracture type and location
- Neurovascular status
- Imaging findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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