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S72.415J vs S72.416J

S72.415J (Nondisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing) compared with S72.416J (Nondisplaced unspecified condyle fracture of lower end of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing), from the official CMS tabular data. S72.415J and S72.416J code the same condition on opposite sides.

Relationship

Review

Laterality relationship

S72.415J
Left
Nondisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
S72.416J
Unspecified
Nondisplaced unspecified condyle fracture of lower end of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing

Same condition; these differ only in which side is documented.

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

Can these codes be reported together?

Same condition, opposite side. S72.415J and S72.416J 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.

Side by side

S72.415JNondisplaced unspecified condyle fracture of lower end of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healingS72.416JNondisplaced unspecified condyle fracture of lower end of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
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 unspecified condyle fracture of lower end of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing is a billable ICD-10-CM diagnosis code (S72.415J).Nondisplaced unspecified condyle fracture of lower end of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing is a billable ICD-10-CM diagnosis code (S72.416J).
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

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