S72.01 vs S72.90XQ

S72.01 (Unspecified intracapsular fracture of femur) compared with S72.90XQ (Unspecified fracture of unspecified femur, subsequent encounter for open fracture type I or II with malunion), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Relationship

Conflict

Excludes1 conflict

S72.90XQ

Unspecified fracture of unspecified femur, subsequent encounter for open fracture type I or II with malunion

↔

S72.01

Unspecified intracapsular fracture of femur

Not coded here — these two are mutually exclusive.

“fracture of hip NOS (S72.00-, S72.01-)”

An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.

Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Can these codes be reported together?

No — do not report together. S72.90XQ carries an Excludes1 note covering S72.01: “fracture of hip NOS (S72.00-, S72.01-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

	S72.01Unspecified intracapsular fracture of femur	S72.90XQUnspecified fracture of unspecified femur, subsequent encounter for open fracture type I or II with malunion
Billing status	Non-billable header	Billable
Classification	S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)	S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
Definition	Unspecified intracapsular fracture of femur is a non-billable ICD-10-CM category code (S72.01).	Unspecified fracture of unspecified femur, subsequent encounter for open fracture type I or II with malunion is a billable ICD-10-CM diagnosis code (S72.90Q).
7th character	The appropriate 7th character is to be added to all codes from category S72	The appropriate 7th character is to be added to all codes from category S72
Includes	Subcapital fracture of femur	—

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Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources