S72.25XE ICD-10-CM Code: Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type I or II with routine healing
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- 7th character
- Required — see the character table on this page
- Tabular directives
- 1 Excludes1 · 7 Excludes2
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.
- MS-DRG 559 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)
- MS-DRG 560 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC (MDC 08)
- MS-DRG 561 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC (MDC 08)
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.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for S72.25XE in the official ICD-10-CM tabular list, quoted as published.
Notes without a marker are published on S72.25XE itself; “inherited from” names the category or block whose note applies here.
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).
- traumatic amputation of hip and thigh (S78.-) Compare S72.25XE vs S78 →
Source: inherited from S72
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- fracture of lower leg and ankle (S82.-) inherited from S72Compare S72.25XE vs S82 →
- fracture of foot (S92.-) inherited from S72Compare S72.25XE vs S92 →
- periprosthetic fracture of prosthetic implant of hip (M97.0-) inherited from S72Compare S72.25XE vs M97.0 →
- burns and corrosions (T20-T32) inherited from S70-S79Compare S72.25XE vs T20 →
- frostbite (T33-T34) inherited from S70-S79Compare S72.25XE vs T33 →
- snake bite (T63.0-) inherited from S70-S79Compare S72.25XE vs T63.0 →
- venomous insect bite or sting (T63.4-) inherited from S70-S79Compare S72.25XE vs T63.4 →
7th Character Guide
"The appropriate 7th character is to be added to all codes from category S72"
- A — initial encounter for closed fracture
- B — initial encounter for open fracture type I or II
- C — initial encounter for open fracture type IIIA, IIIB, or IIIC
- D — subsequent encounter for closed fracture with routine healing
- E — subsequent encounter for open fracture type I or II with routine healing (this page’s code)
- F — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- G — subsequent encounter for closed fracture with delayed healing
- H — subsequent encounter for open fracture type I or II with delayed healing
- J — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- K — subsequent encounter for closed fracture with nonunion
- M — subsequent encounter for open fracture type I or II with nonunion
- N — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- P — subsequent encounter for closed fracture with malunion
- Q — subsequent encounter for open fracture type I or II with malunion
- R — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S — sequela
How the encounter character is assigned. “Initial encounter” means the patient is receiving active treatment for the condition — it is not limited to the first visit, and a different or new provider giving active treatment still assigns it. “Subsequent encounter” covers care during the healing or recovery phase after active treatment. “Sequela” is for complications or conditions that arise as a direct result of the original condition.
ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.19.a (paraphrased by MedCoder).
Variant codes in this family
S72.25XA, S72.25XB, S72.25XC, S72.25XD, S72.25XE, S72.25XF, S72.25XG, S72.25XH, S72.25XJ, S72.25XK, S72.25XM, S72.25XN, S72.25XP, S72.25XQ, S72.25XR, S72.25XS
Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Official Coding Guidelines
Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.
Chapter 19: Injury, poisoning, and certain other consequences of external causes (S00-T88)
c. Coding of Traumatic Fractures The principles of multiple coding of injuries should be followed in coding fractures. Fractures of specified sites are coded individually by site in accordance with both the provisions within categories S02, S12, S22, S32, S42, S49, S52, S59, S62, S72, S79, S82, S89, S92 and the level of detail furnished by medical record content.
Decision Points
The directives on this code's own record, as a pre-claim checklist.
- A 7th character applies in this family. Confirm the documented encounter matches the character assigned. See the official 7th-character definitions and this code’s variants
- Laterality is coded in this family. Confirm the documented side matches the code — the opposite-side siblings are in the relationships section. See the opposite-side sibling codes
- 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
- 7 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes
Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.
Verify Before Coding
- No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
Other codes that name S72.25XE or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 3 Excludes1 notes across 2 chapters: M84.3 — Stress fracture (via S72.-), M84.4 — Pathological fracture, not elsewhere classified (via S72.-), S71 — Open wound of hip and thigh (via S72.-).
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
MS-DRG Grouper Relationships (FY2026)
Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.
Potential MS-DRG participation — not a DRG assignment.
Named in the grouper logic of 3 MS-DRGs: DRG 559 (MDC 08), DRG 560 (MDC 08), DRG 561 (MDC 08).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):INJ043 — Fracture of the neck of the femur (hip), subsequent encounter (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Related Codes
Same condition, opposite side
Same category and title, differing only in which side of the body is affected.
S72.24XE — Nondisplaced subtrochanteric fracture of right femur, subsequent encounter for open fracture type I or II with routine healing (right)Compare S72.25XE vs S72.24XE →, S72.26XE — Nondisplaced subtrochanteric fracture of unspecified femur, subsequent encounter for open fracture type I or II with routine healing (unspecified)Compare S72.25XE vs S72.26XE →
Same injury, other encounter phase
Same injury, coded at a different phase of treatment via the 7th character.
S72.25XA — Nondisplaced subtrochanteric fracture of left femur, initial encounter for closed fractureCompare S72.25XE vs S72.25XA →, S72.25XB — Nondisplaced subtrochanteric fracture of left femur, initial encounter for open fracture type I or II, S72.25XC — Nondisplaced subtrochanteric fracture of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC, S72.25XD — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for closed fracture with routine healing, S72.25XF — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing, S72.25XG — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for closed fracture with delayed healing, S72.25XH — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type I or II with delayed healing, S72.25XJ — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing, S72.25XK — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for closed fracture with nonunion, S72.25XM — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type I or II with nonunion, S72.25XN — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion, S72.25XP — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for closed fracture with malunion, S72.25XQ — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type I or II with malunion, S72.25XR — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion, S72.25XS — Nondisplaced subtrochanteric fracture of left femur, sequela
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Fracture of the neck of the femur (hip), subsequent encounter).
Contextual Map
Every relationship of S72.25XE 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.
Run S72.25XE with these 3 related codes in Claim Check
Hierarchy
- S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- S70-S79 — Injuries to the hip and thigh[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Referenced by Excludes1 notes
- M84.3 — Stress fracture[Excludes1](via S72.-): “traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- M84.4 — Pathological fracture, not elsewhere classified[Excludes1](via S72.-): “traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- S71 — Open wound of hip and thigh[Excludes1](via S72.-): “open fracture of hip and thigh (S72.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Clinical classification (CCSR)
- INJ043 — Fracture of the neck of the femur (hip), subsequent encounter[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- DRG 559 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC[MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 560 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC[MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC (MDC 08)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 561 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC[MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC (MDC 08)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
MDC crossing
- 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. 18,508 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
Nearest codes (40)
- S72 — Fracture of femur[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- S72.24XB — Nondisplaced subtrochanteric fracture of right femur, initial encounter for open fracture type I or II[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- S72.24XC — Nondisplaced subtrochanteric fracture of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- S72.24XD — Nondisplaced subtrochanteric fracture of right femur, subsequent encounter for closed fracture with routine healing[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- S72.24XE — Nondisplaced subtrochanteric fracture of right femur, subsequent encounter for open fracture type I or II with routine healing[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- S72.24XF — Nondisplaced subtrochanteric fracture of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- S72.24XG — Nondisplaced subtrochanteric fracture of right femur, subsequent encounter for closed fracture with delayed healing[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- S72.24XH — Nondisplaced subtrochanteric fracture of right femur, subsequent encounter for open fracture type I or II with delayed healing[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 32 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Common coding questions
Does S72.25XE require a 7th character?
Yes. The appropriate 7th character is to be added to all codes from category S72.
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Coding guidelines Official source data
- ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionNondisplaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type I or II with routine healing
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to S72.25XE in its code family, with their registry titles.
- S72.25 — Nondisplaced subtrochanteric fracture of left femur
- S72.25XA — Nondisplaced subtrochanteric fracture of left femur, initial encounter for closed fracture
- S72.25XB — Nondisplaced subtrochanteric fracture of left femur, initial encounter for open fracture type I or II
- S72.25XC — Nondisplaced subtrochanteric fracture of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S72.25XD — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for closed fracture with routine healing
- S72.25XF — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S72.25XG — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for closed fracture with delayed healing
- S72.25XH — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type I or II with delayed healing
- S72.25XJ — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
- S72.25XK — Nondisplaced subtrochanteric fracture of left femur, subsequent encounter for closed fracture with nonunion