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S72.90XQ vs S78

S72.90XQ (Unspecified fracture of unspecified femur, subsequent encounter for open fracture type I or II with malunion) compared with S78 (Traumatic amputation of hip and thigh), 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
↔
S78
Traumatic amputation of hip and thigh

Not coded here — these two are mutually exclusive.

“traumatic amputation of hip and thigh (S78.-)”

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 S78: “traumatic amputation of hip and thigh (S78.-)”

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

S72.90XQUnspecified fracture of unspecified femur, subsequent encounter for open fracture type I or II with malunionS78Traumatic amputation of hip and thigh
Billing statusBillableNon-billable header

Report instead: S78.011A, S78.011D, S78.011S, S78.012A, S78.012D

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)
DefinitionUnspecified 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).Traumatic amputation of hip and thigh is a non-billable ICD-10-CM category code (S78).
7th characterThe appropriate 7th character is to be added to all codes from category S72The appropriate 7th character is to be added to each code from category S78
Includes—
An amputation not identified as partial or complete should be coded to complete
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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