2025 ICD-10-CM code S72.90XA
(Active) Effective Date: N/A Revision Date: N/A Injury - Injuries to the hip and thigh Injury, poisoning and certain other consequences of external causes (S00-T88) Feed
Unspecified fracture of unspecified femur, initial encounter for closed fracture.
Modifiers may be applicable depending on the circumstances of the encounter and the services provided.Consult current coding guidelines for appropriate modifier usage.
Medical necessity for treatment of a femoral fracture is typically established based on the presence of a fracture demonstrable by imaging and documented pain and functional impairment caused by the fracture. Treatment is medically necessary to restore structural integrity of the bone, reduce pain, and restore functional mobility to the patient's leg.
The clinical responsibility includes the initial assessment and diagnosis of the fracture, the ordering and interpretation of relevant imaging studies (e.g., X-rays), and the implementation of appropriate treatment plan, such as reduction (realignment of the bone fragments), immobilization (e.g., casting or splinting), and pain management.
- Injury, poisoning and certain other consequences of external causes (S00-T88)
- S70-S79 (Injuries to the hip and thigh)
In simple words: This code is used when someone has a broken thigh bone (femur), and it's the first time this injury is treated, and the skin isn't broken. The exact place where the bone is broken isn't known.
This ICD-10-CM code classifies an unspecified fracture of the femur (thigh bone), which is the initial encounter for a closed fracture.The term "unspecified" indicates that the exact location of the fracture on the femur is unknown or not specified in the medical record.A closed fracture means the skin is not broken at the site of the fracture.
Example 1: A patient presents to the emergency department after a fall, complaining of severe pain in their thigh. X-rays reveal a closed fracture of the femur, but the precise location cannot be determined immediately. Code S72.90XA is used., An elderly patient with osteoporosis falls at home and suffers a closed femoral fracture.The location is not immediately clear, so S72.90XA is used pending further imaging studies. , A patient is involved in a motor vehicle accident and sustains multiple injuries. Among them is a closed fracture of the femur, the exact location of which is unclear due to the severity of other injuries. Code S72.90XA is assigned, along with other appropriate codes for the other injuries.
Detailed patient history including the mechanism of injury, a complete physical examination focusing on the affected leg, and radiographic images (X-rays) demonstrating the fracture.If the fracture location is known, it should be documented.Further documentation of treatment plan and surgical intervention (if applicable) is also required.
** This code should be used only when the location of the femoral fracture is truly unspecified.Any additional information that refines the location of the fracture should be used to select a more precise code.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Orthopedics, Emergency Medicine, Trauma Surgery
- Place of Service:Emergency Room - Hospital, Inpatient Hospital, Office, Outpatient Hospital