S72.91XA (Unspecified fracture of right femur, initial encounter for closed fracture) compared with S72.91XE (Unspecified fracture of right femur, subsequent encounter for open fracture type I or II with routine healing), from the official CMS tabular data. S72.91XA and S72.91XE code the same injury at a different phase of treatment.
Same underlying diagnosis, different encounter phase.
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: ICD-10-CM Official Guidelines, Section I.C.19.a
Same injury, other encounter phase. S72.91XA and S72.91XE 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.
| S72.91XAUnspecified fracture of right femur, initial encounter for closed fracture | S72.91XEUnspecified fracture of right femur, subsequent encounter for open fracture type I or II with routine healing | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | S00-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) |
| Definition | Unspecified fracture of right femur, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S72.91A). | Unspecified fracture of right femur, subsequent encounter for open fracture type I or II with routine healing is a billable ICD-10-CM diagnosis code (S72.91E). |
| 7th character | The appropriate 7th character is to be added to all codes from category S72 | The 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