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S72.23XB ICD-10-CM Code: Displaced subtrochanteric fracture of unspecified femur, initial encounter for open fracture type I or II

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 521 — HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC (MDC 08)
  • MS-DRG 522 — HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC (MDC 08)
  • MS-DRG 535 — FRACTURES OF HIP AND PELVIS WITH MCC (MDC 08)
  • MS-DRG 536 — FRACTURES OF HIP AND PELVIS WITHOUT MCC (MDC 08)
  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)
  • MS-DRG 964 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC (MDC 24)
  • MS-DRG 965 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC (MDC 24)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 402 — Hip Fracture/Dislocation

Other models: CMS-HCC V22 HCC 170

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Official Registry Overview & Definition

Displaced subtrochanteric fracture of unspecified femur, initial encounter for open fracture type I or II is a billable ICD-10-CM diagnosis code (S72.23B).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S72.23XB in the official ICD-10-CM tabular list.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Frequently Compared Codes

The official Excludes notes on S72.23XB name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.

Verify Before Coding

  • MCC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Relationships & Classification

Official ICD-10-CM tabular notes on other codes that name S72.23XB or its code family.

3 Excludes1 notes across 2 chapters: M84.3 (via S72.-), M84.4 (via S72.-), S71 (via S72.-).

Potential MS-DRG Relationships (FY2026)

MCC — Major Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 814 clinically related codes on its CMS exclusion list. Does not count toward severity when the stay groups to DRGs 957-959 (Other O.R. Procedures for Multiple Significant Trauma); DRGs 963-965 (Other Multiple Significant Trauma).

Named in the grouper logic of 9 MS-DRGs: DRG 521 (MDC 08), DRG 522 (MDC 08), DRG 535 (MDC 08), DRG 536 (MDC 08), DRG 791 (MDC 15), DRG 793 (MDC 15), DRG 963 (MDC 24), DRG 964 (MDC 24), DRG 965 (MDC 24).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):INJ006 — Fracture of the neck of the femur (hip), initial encounter (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Contextual Map

Every relationship of S72.23XB in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88) [Hierarchy]
  • S70-S79 — Injuries to the hip and thigh [Hierarchy]

Referenced by Excludes1 notes

  • M84.3 — Stress fracture [Excludes1](via S72.-): “traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)” · check together
  • M84.4 — Pathological fracture, not elsewhere classified [Excludes1](via S72.-): “traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)” · check together
  • S71 — Open wound of hip and thigh [Excludes1](via S72.-): “open fracture of hip and thigh (S72.-)” · check together

Clinical classification (CCSR)

  • INJ006 — Fracture of the neck of the femur (hip), initial encounter [CCSR]

Risk adjustment (CMS-HCC)

  • HCC 402 — Hip Fracture/Dislocation [CMS-HCC]

Potential MS-DRG (9)

  • MCC — Major Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (MCC). Not counted when the stay groups to DRGs 957-959 (Other O.R. Procedures for Multiple Significant Trauma); DRGs 963-965 (Other Multiple Significant Trauma).”
  • DRG 521 — HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC [MS-DRG]: “HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC (MDC 08)”
  • DRG 522 — HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC [MS-DRG]: “HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC (MDC 08)”
  • DRG 535 — FRACTURES OF HIP AND PELVIS WITH MCC [MS-DRG]: “FRACTURES OF HIP AND PELVIS WITH MCC (MDC 08)”
  • DRG 536 — FRACTURES OF HIP AND PELVIS WITHOUT MCC [MS-DRG]: “FRACTURES OF HIP AND PELVIS WITHOUT MCC (MDC 08)”
  • DRG 791 — PREMATURITY WITH MAJOR PROBLEMS [MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”
  • DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS [MS-DRG]: “FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)”
  • DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)”
  • and 2 more

MDC crossing · procedures (41465)

  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue [MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period [MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 005T0ZZ — Destruction of Spinal Meninges, Open Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T3ZZ — Destruction of Spinal Meninges, Percutaneous Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T4ZZ — Destruction of Spinal Meninges, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Endoscopic Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0Z3 — Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0ZZ — Destruction of Cervical Spinal Cord, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • and 41460 more

Nearest codes (40)

  • S72 — Fracture of femur [Sibling]
  • S72.21XS — Displaced subtrochanteric fracture of right femur, sequela [Sibling]
  • S72.22 — Displaced subtrochanteric fracture of left femur [Sibling]
  • S72.22XA — Displaced subtrochanteric fracture of left femur, initial encounter for closed fracture [Sibling]
  • S72.22XB — Displaced subtrochanteric fracture of left femur, initial encounter for open fracture type I or II [Sibling]
  • S72.22XC — Displaced subtrochanteric fracture of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC [Sibling]
  • S72.22XD — Displaced subtrochanteric fracture of left femur, subsequent encounter for closed fracture with routine healing [Sibling]
  • S72.22XE — Displaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type I or II with routine healing [Sibling]
  • and 32 more

Frequently Asked Questions (FAQ) & Clinical Guidance

Does S72.23XB require a 7th character?

Yes. The appropriate 7th character is to be added to all codes from category S72.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S72.23XB in its code family, with their registry titles.

  • S72.22XQ — Displaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type I or II with malunion
  • S72.22XR — Displaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
  • S72.22XS — Displaced subtrochanteric fracture of left femur, sequela
  • S72.23 — Displaced subtrochanteric fracture of unspecified femur
  • S72.23XA — Displaced subtrochanteric fracture of unspecified femur, initial encounter for closed fracture
  • S72.23XC — Displaced subtrochanteric fracture of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
  • S72.23XD — Displaced subtrochanteric fracture of unspecified femur, subsequent encounter for closed fracture with routine healing
  • S72.23XE — Displaced subtrochanteric fracture of unspecified femur, subsequent encounter for open fracture type I or II with routine healing
  • S72.23XF — Displaced subtrochanteric fracture of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
  • S72.23XG — Displaced subtrochanteric fracture of unspecified femur, subsequent encounter for closed fracture with delayed healing

View all codes in the S72 family