Fracture of femur
In Injuries to the hip and thigh (S70-S79), chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes
2,466 billable codes under S72: 417 are an MCC, 969 are a CC; 462 map to HCC 402 (Hip Fracture/Dislocation).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.
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Instructional notes
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
- Section I.C.19.c Coding of Traumatic Fractures (page 79), covers S72
Code fractures by site; default to closed and displaced when not specified. Use initial 7th characters during active treatment and subsequent ones during healing, not aftercare Z codes; use M80 for osteoporotic fractures from minor trauma.
Other Chapter 19 topics:
- Application of 7th Characters in Chapter 19 (page 77)
- Coding of Injuries (page 78)
- Coding of Burns and Corrosions (page 80)
- Adverse Effects, Poisoning, Underdosing and Toxic Effects (page 82)
- Adult and child abuse, neglect and other maltreatment (page 85)
- Complications of care (page 85)
Codes under S72
S72 can't be used on a claim. Pick a billable code below; grey headings group them.
S72 MS-DRGs
As the principal diagnosis, the billable codes under S72 group to these 17 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 559 Aftercare, Musculoskeletal System and Connective Tissue with MCC (1080 of 2466 codes)
- DRG 560 Aftercare, Musculoskeletal System and Connective Tissue with CC (1080 of 2466 codes)
- DRG 561 Aftercare, Musculoskeletal System and Connective Tissue without CC/MCC (1080 of 2466 codes)
- DRG 564 Other Musculoskeletal System and Connective Tissue Diagnoses with MCC (924 of 2466 codes)
- DRG 565 Other Musculoskeletal System and Connective Tissue Diagnoses with CC (924 of 2466 codes)
- DRG 566 Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCC (924 of 2466 codes)
- DRG 521 Hip Replacement with Principal Diagnosis of Hip Fracture with MCC (828 of 2466 codes)
- DRG 522 Hip Replacement with Principal Diagnosis of Hip Fracture without MCC (828 of 2466 codes)
- DRG 963 Other Multiple Significant Trauma with MCC (462 of 2466 codes)
- DRG 964 Other Multiple Significant Trauma with CC (462 of 2466 codes)
- DRG 965 Other Multiple Significant Trauma without CC/MCC (462 of 2466 codes)
- DRG 791 Prematurity with Major Problems (333 of 2466 codes)
- DRG 793 Full Term Neonate with Major Problems (333 of 2466 codes)
- DRG 533 Fractures of Femur with MCC (255 of 2466 codes)
- DRG 534 Fractures of Femur without MCC (255 of 2466 codes)
- DRG 535 Fractures of Hip and Pelvis with MCC (207 of 2466 codes)
- DRG 536 Fractures of Hip and Pelvis without MCC (207 of 2466 codes)
Other codes that refer to S72
Notes on these codes point to S72.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Fractures
A fracture is a break in a bone. Fractures are usually caused by injuries. Since they can sometimes be serious, it's important to get medical care right away if you think you have a fracture.
Read more about fractures on MedlinePlusLeg Injuries and Disorders
Your legs are made up of bones, blood vessels, muscles, and other connective tissue. They are important for motion and standing. Playing sports, running, falling, or having an accident can damage your legs. Common leg injuries include sprains and strains, joint dislocations, and fractures (broken bones).
Read more about leg injuries and disorders on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.