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ICD-10/S72.90XC

S72.90XC ICD-10-CM Code: Unspecified fracture of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC

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 (FY2026), Appendix B.

  • MS-DRG 533 — FRACTURES OF FEMUR WITH MCC (MDC 08)
  • MS-DRG 534 — FRACTURES OF FEMUR 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 Set: Valid FY2026 and FY2027. FY2026 took effect October 1, 2025.

Official Registry Overview & Definition

Unspecified fracture of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC is a billable ICD-10-CM diagnosis code (S72.90C).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S72.90XC in the official ICD-10-CM tabular list.

Excludes1 — Not Coded Here

Conditions that can never be reported with this code; the two are mutually exclusive.

  • fracture of hip NOS (S72.00-, S72.01-)
  • traumatic amputation of hip and thigh (S78.-)

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.-)
  • fracture of foot (S92.-)
  • periprosthetic fracture of prosthetic implant of hip (M97.0-)
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • snake bite (T63.0-)
  • venomous insect bite or sting (T63.4-)

Frequently Asked Questions (FAQ) & Clinical Guidance

Does S72.90XC 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 S72.90XC in its code family, with their registry titles.

  • S72.8X9S — Other fracture of unspecified femur, sequela
  • S72.9 — Unspecified fracture of femur
  • S72.90 — Unspecified fracture of unspecified femur
  • S72.90XA — Unspecified fracture of unspecified femur, initial encounter for closed fracture
  • S72.90XB — Unspecified fracture of unspecified femur, initial encounter for open fracture type I or II
  • S72.90XD — Unspecified fracture of unspecified femur, subsequent encounter for closed fracture with routine healing
  • S72.90XE — Unspecified fracture of unspecified femur, subsequent encounter for open fracture type I or II with routine healing
  • S72.90XF — Unspecified fracture of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
  • S72.90XG — Unspecified fracture of unspecified femur, subsequent encounter for closed fracture with delayed healing
  • S72.90XH — Unspecified fracture of unspecified femur, subsequent encounter for open fracture type I or II with delayed healing

View all codes in the S72 family