Skip to main content

S72.091A vs S72.091Q

S72.091A (Other fracture of head and neck of right femur, initial encounter for closed fracture) compared with S72.091Q (Other fracture of head and neck of right femur, subsequent encounter for open fracture type I or II with malunion), from the official CMS tabular data. S72.091A and S72.091Q code the same injury at a different phase of treatment. MedCoder-derived

Can these codes be reported together?

Review

Encounter relationship

S72.091A
Initial encounter
Other fracture of head and neck of right femur, initial encounter for closed fracture
↔
S72.091Q
Subsequent encounter
Other fracture of head and neck of right femur, subsequent encounter for open fracture type I or II with malunion

What we found

Same injury, other encounter phase.S72.091A and S72.091Q code the same injury at a different phase of treatment, set by the 7th character.

The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.

What to review

Use the 7th character that matches the encounter being coded (initial, subsequent or sequela); one encounter takes one of them.

Guide: 7th characters: initial, subsequent, sequelaCheck these on a claim

Why it matters

The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.

Source / rule

ICD-10-CM Official Guidelines, Section I.C.19.a

Side by side

S72.091AOther fracture of head and neck of right femur, initial encounter for closed fractureS72.091QOther fracture of head and neck of right femur, subsequent encounter for open fracture type I or II with malunion
Billing statusBillableBillable
ClassificationS00-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)
DefinitionOther fracture of head and neck of right femur, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S72.091A).Other fracture of head and neck of right femur, subsequent encounter for open fracture type I or II with malunion is a billable ICD-10-CM diagnosis code (S72.091Q).
7th characterThe appropriate 7th character is to be added to all codes from category S72The appropriate 7th character is to be added to all codes from category S72
Excludes1
traumatic amputation of hip and thigh (S78.-)
traumatic amputation of hip and thigh (S78.-)
Excludes2
physeal fracture of lower end of femur (S79.1-)
physeal fracture of upper end of femur (S79.0-)
fracture of lower leg and ankle (S82.-)
fracture of foot (S92.-)
periprosthetic fracture of prosthetic implant of hip (M97.0-)
burns and corrosions (T20-T32)
frostbite (T33-T34)
snake bite (T63.0-)
venomous insect bite or sting (T63.4-)
physeal fracture of lower end of femur (S79.1-)
physeal fracture of upper end of femur (S79.0-)
fracture of lower leg and ankle (S82.-)
fracture of foot (S92.-)
periprosthetic fracture of prosthetic implant of hip (M97.0-)
burns and corrosions (T20-T32)
frostbite (T33-T34)
snake bite (T63.0-)
venomous insect bite or sting (T63.4-)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

Edit this comparisonCheck a whole claim

Derived from the official CMS ICD-10-CM tabular data (FY2026). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources