2025 ICD-10-CM code S72

Fracture of the femur.

Appropriate use of additional codes to specify the fracture type (open vs. closed, displaced vs. non-displaced), the location of the fracture within the femur (shaft, neck, etc.), and the cause of the injury is crucial for accurate coding and reimbursement.

Modifiers may be used to indicate the extent of the procedure or the location of the service.For example, modifiers may be needed to specify laterality (left or right), or to denote multiple procedures.

Medical necessity for treatment of a femoral fracture is established by the presence of a fracture confirmed by imaging, along with the associated pain, functional limitations, and potential for long-term complications if left untreated.Treatment options are determined by the fracture characteristics and patient-specific factors.

Orthopedic surgeons are typically responsible for diagnosing and managing femoral fractures. The clinical responsibility includes conducting physical exams, ordering and interpreting imaging studies (X-rays, CT scans, MRI), determining the appropriate treatment plan (surgical or non-surgical), performing surgery if needed (ORIF, external fixation), managing pain and complications, and overseeing the patient's rehabilitation.Other healthcare professionals, such as nurses, physical therapists, and anesthesiologists, also play a crucial role in the patient's care.

IMPORTANT Additional codes may be required to specify the type of fracture (e.g., open vs. closed, displaced vs. non-displaced), and to indicate the cause of injury (using codes from Chapter 20, External causes of morbidity).

In simple words: A broken thigh bone (femur) is a serious injury that usually requires medical attention. It can happen from a fall, car accident, or sports injury.The pain can be severe, and you might have swelling and bruising. Doctors use X-rays and other tests to determine the best way to repair the break, which often involves surgery. After surgery, physical therapy helps you regain strength and mobility.

A fracture of the femur, the thigh bone, is a break or discontinuity in the bone, with or without displacement of the fracture fragments.It can result from various causes including high-impact trauma (falls, motor vehicle accidents), low-impact trauma in individuals with weakened bones (osteoporosis), or other underlying conditions.The injury may present with severe pain, swelling, bruising, deformity, and difficulty moving the leg. Diagnostic methods include physical examination, X-rays, CT scans, and possibly MRI or bone scans. Treatment options vary depending on the fracture type and severity and may include closed reduction, open reduction and internal fixation (ORIF), external fixation, pain management, and physical therapy.

Example 1: A 25-year-old male involved in a high-speed motorcycle accident sustains a comminuted open fracture of the right femur. The fracture is unstable and requires open reduction and internal fixation (ORIF) with intramedullary nailing., A 78-year-old female with osteoporosis falls at home and suffers a non-displaced closed fracture of the left femur.She is treated with a hip spica cast and pain medication., A 16-year-old male athlete sustains a spiral fracture of the femur during a football game. He undergoes surgery with intramedullary rod placement, followed by intensive physical therapy.

Complete patient history, including mechanism of injury.Detailed physical examination findings.Radiographic images (X-rays, CT scans, potentially MRI).Surgical notes if applicable.Progress notes documenting pain management, rehabilitation progress and any complications.Copies of operative reports.Post-operative imaging (x-rays) to monitor healing progress. Pathology reports, if a pathological fracture is suspected.

** Specific codes for the type of fracture and the method of treatment are essential.Always consult the latest ICD-10-CM coding guidelines and payer-specific requirements.

  • Payment Status: Active
  • Specialties:Orthopedic surgery
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Emergency Room - Hospital
** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.