Skip to main content

S72.26XA ICD-10-CM Code: Nondisplaced subtrochanteric fracture of unspecified femur, initial encounter for closed fracture

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
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 170

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 v43.0, 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.

Code Overview

Nondisplaced subtrochanteric fracture of unspecified femur, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S72.26XA).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S72.26XA in the official ICD-10-CM tabular list.

Notes without a marker are published on S72.26XA 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).

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.

7th Character Guide

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

  • A — initial encounter for closed fracture (this page’s code)
  • 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
  • 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

S72.26XA, S72.26XB, S72.26XC, S72.26XD, S72.26XE, S72.26XF, S72.26XG, S72.26XH, S72.26XJ, S72.26XK, S72.26XM, S72.26XN, S72.26XP, S72.26XQ, S72.26XR, S72.26XS

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.

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.

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Nondisplaced subtrochanteric fracture of unspecified femur, initial encounter for closed fracture

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.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 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
  2. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  3. 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

  • 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 in Claim Check.

Relationships & Classification

Other codes that name S72.26XA 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)

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).

Potential MS-DRG participation — not a DRG assignment.

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.

Related Codes

Same condition, opposite side

Same category and title, differing only in which side of the body is affected.

S72.24XA — Nondisplaced subtrochanteric fracture of right femur, initial encounter for closed fracture (right)Compare S72.26XA vs S72.24XA →, S72.25XA — Nondisplaced subtrochanteric fracture of left femur, initial encounter for closed fracture (left)Compare S72.26XA vs S72.25XA →

Same injury, other encounter phase

Same injury, coded at a different phase of treatment via the 7th character.

S72.26XB — Nondisplaced subtrochanteric fracture of unspecified femur, initial encounter for open fracture type I or IICompare S72.26XA vs S72.26XB →, S72.26XC — Nondisplaced subtrochanteric fracture of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIICCompare S72.26XA vs S72.26XC →, S72.26XD — Nondisplaced subtrochanteric fracture of unspecified femur, subsequent encounter for closed fracture with routine healingCompare S72.26XA vs S72.26XD →, S72.26XE — Nondisplaced subtrochanteric fracture of unspecified femur, subsequent encounter for open fracture type I or II with routine healingCompare S72.26XA vs S72.26XE →, S72.26XF — Nondisplaced subtrochanteric fracture of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healingCompare S72.26XA vs S72.26XF →, S72.26XG — Nondisplaced subtrochanteric fracture of unspecified femur, subsequent encounter for closed fracture with delayed healingCompare S72.26XA vs S72.26XG →, S72.26XH — Nondisplaced subtrochanteric fracture of unspecified femur, subsequent encounter for open fracture type I or II with delayed healingCompare S72.26XA vs S72.26XH →, S72.26XJ — Nondisplaced subtrochanteric fracture of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healingCompare S72.26XA vs S72.26XJ →, S72.26XK — Nondisplaced subtrochanteric fracture of unspecified femur, subsequent encounter for closed fracture with nonunionCompare S72.26XA vs S72.26XK →, S72.26XM — Nondisplaced subtrochanteric fracture of unspecified femur, subsequent encounter for open fracture type I or II with nonunionCompare S72.26XA vs S72.26XM →, S72.26XN — Nondisplaced subtrochanteric fracture of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunionCompare S72.26XA vs S72.26XN →, S72.26XP — Nondisplaced subtrochanteric fracture of unspecified femur, subsequent encounter for closed fracture with malunionCompare S72.26XA vs S72.26XP →, S72.26XQ — Nondisplaced subtrochanteric fracture of unspecified femur, subsequent encounter for open fracture type I or II with malunionCompare S72.26XA vs S72.26XQ →, S72.26XR — Nondisplaced subtrochanteric fracture of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunionCompare S72.26XA vs S72.26XR →, S72.26XS — Nondisplaced subtrochanteric fracture of unspecified femur, sequelaCompare S72.26XA vs S72.26XS →

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Hip Fracture/Dislocation) for risk-adjusted payment.

S72.22XC — Displaced subtrochanteric fracture of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC, S72.23XA — Displaced subtrochanteric fracture of unspecified femur, initial encounter for closed fracture, S72.23XB — Displaced subtrochanteric fracture of unspecified femur, initial encounter for open fracture type I or II, S72.23XC — Displaced subtrochanteric fracture of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC, S72.24XA — Nondisplaced subtrochanteric fracture of right femur, initial encounter for closed fracture, S72.24XB — Nondisplaced subtrochanteric fracture of right femur, initial encounter for open fracture type I or II, S72.24XC — Nondisplaced subtrochanteric fracture of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC, 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, S72.26XB — Nondisplaced subtrochanteric fracture of unspecified femur, initial encounter for open fracture type I or II, S72.26XC — Nondisplaced subtrochanteric fracture of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC, S72.301A — Unspecified fracture of shaft of right femur, initial encounter for closed fracture, S72.301B — Unspecified fracture of shaft of right femur, initial encounter for open fracture type I or II, S72.301C — Unspecified fracture of shaft of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC, S72.302A — Unspecified fracture of shaft of left femur, initial encounter for closed fracture, S72.302B — Unspecified fracture of shaft of left femur, initial encounter for open fracture type I or II, S72.302C — Unspecified fracture of shaft of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC, S72.309A — Unspecified fracture of shaft of unspecified femur, initial encounter for closed fracture, S72.309B — Unspecified fracture of shaft of unspecified femur, initial encounter for open fracture type I or II, +708 more

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), initial encounter).

S72.146A — Nondisplaced intertrochanteric fracture of unspecified femur, initial encounter for closed fracture, S72.146B — Nondisplaced intertrochanteric fracture of unspecified femur, initial encounter for open fracture type I or II, S72.146C — Nondisplaced intertrochanteric fracture of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC, S72.21XA — Displaced subtrochanteric fracture of right femur, initial encounter for closed fracture, S72.21XB — Displaced subtrochanteric fracture of right femur, initial encounter for open fracture type I or II, S72.21XC — Displaced subtrochanteric fracture of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC, S72.22XA — Displaced subtrochanteric fracture of left femur, initial encounter for closed fracture, S72.22XB — Displaced subtrochanteric fracture of left femur, initial encounter for open fracture type I or II, S72.22XC — Displaced subtrochanteric fracture of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC, S72.23XA — Displaced subtrochanteric fracture of unspecified femur, initial encounter for closed fracture, S72.23XB — Displaced subtrochanteric fracture of unspecified femur, initial encounter for open fracture type I or II, S72.23XC — Displaced subtrochanteric fracture of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC, S72.24XA — Nondisplaced subtrochanteric fracture of right femur, initial encounter for closed fracture, S72.24XB — Nondisplaced subtrochanteric fracture of right femur, initial encounter for open fracture type I or II, S72.24XC — Nondisplaced subtrochanteric fracture of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC, 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, S72.26XB — Nondisplaced subtrochanteric fracture of unspecified femur, initial encounter for open fracture type I or II, S72.26XC — Nondisplaced subtrochanteric fracture of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC, +188 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of S72.26XA 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

Referenced by Excludes1 notes

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

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

MS-DRG Grouper (9)

MDC crossing

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]

Frequently Asked Questions (FAQ) & Clinical Guidance

Does S72.26XA 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 S72.26XA in its code family, with their registry titles.

View all codes in the S72 family