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S72.491C vs S72.499C

S72.491C (Other fracture of lower end of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC) compared with S72.499C (Other fracture of lower end of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC), from the official CMS tabular data. S72.491C and S72.499C code the same condition on opposite sides.

Relationship

Review

Laterality relationship

S72.491C
Right
Other fracture of lower end of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
S72.499C
Unspecified
Other fracture of lower end of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC

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. S72.491C and S72.499C 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

S72.491COther fracture of lower end of right femur, initial encounter for open fracture type IIIA, IIIB, or IIICS72.499COther fracture of lower end of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
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 lower end of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC is a billable ICD-10-CM diagnosis code (S72.491C).Other fracture of lower end of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC is a billable ICD-10-CM diagnosis code (S72.499C).
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