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S72.354R vs S72.356R

S72.354R (Nondisplaced comminuted fracture of shaft of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion) compared with S72.356R (Nondisplaced comminuted fracture of shaft of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion), from the official CMS tabular data.

Summary

These codes name the same condition on opposite sides of the body, so the documented side decides which one applies.

MedCoder-derived
What is different?

Title wording.The titles differ in one word, “right” (S72.354R) versus “unspecified” (S72.356R): S72.354R is “Nondisplaced comminuted fracture of shaft of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion”; S72.356R is “Nondisplaced comminuted fracture of shaft of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion”.

Registry fact

Can these codes be reported together?

One side per condition.S72.354R and S72.356R name the same condition on opposite sides of the body. Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.

MedCoder-derivedGuide: Laterality coding

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. S72.354R carries 1 Excludes1 note and S72.356R carries 1 Excludes1 note covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code. S72.354R carries 7 Excludes2 notes and S72.356R carries 7 Excludes2 notes covering other codes; the side-by-side table quotes them.

Official rule

Is one more specific?

Yes.S72.354R’s title names the condition; S72.356R’s title is the unspecified form (“Nondisplaced comminuted fracture of shaft of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion”).

MedCoder-derivedGuide: Other vs unspecified (NEC vs NOS)

Is one a parent or header code?

No.Both are billable codes, and neither contains the other.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

Yes.Same condition, opposite side. S72.354R and S72.356R name the same condition on opposite sides of the body.

MedCoder-derivedGuide: Laterality coding

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule.

Can these codes be reported together?

Review

Laterality relationship

S72.354R
Right
Nondisplaced comminuted fracture of shaft of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
↔
S72.356R
Unspecified
Nondisplaced comminuted fracture of shaft of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion

What we found

Same condition, opposite side.S72.354R and S72.356R name the same condition on opposite sides of the body.

Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.

What to review

Report the side the documentation names. Where the code set provides a bilateral code and both sides are documented, use it instead of the pair.

Guide: Laterality codingCheck these on a claim

Why it matters

These codes share a category and title and differ only in the side affected. The documentation decides which applies, and a bilateral code is reported only where the code set provides one.

Source / rule

ICD-10-CM tabular list (laterality variant derived from the code title)

Side by side

S72.354RNondisplaced comminuted fracture of shaft of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunionS72.356RNondisplaced comminuted fracture of shaft of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC 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)
DefinitionNondisplaced comminuted fracture of shaft of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion is a billable ICD-10-CM diagnosis code (S72.354R).Nondisplaced comminuted fracture of shaft of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion is a billable ICD-10-CM diagnosis code (S72.356R).
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
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-)
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.

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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