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S72.92XF ICD-10-CM Code: Unspecified fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC 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
2 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 v43.0, 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.

Code Overview

Unspecified fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing is a billable ICD-10-CM diagnosis code (S72.92XF).

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 S72.92XF in the official ICD-10-CM tabular list.

Notes without a marker are published on S72.92XF 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).

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
  • 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 (this page’s code)
  • 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

S72.92XA, S72.92XB, S72.92XC, S72.92XD, S72.92XE, S72.92XF, S72.92XG, S72.92XH, S72.92XJ, S72.92XK, S72.92XM, S72.92XN, S72.92XP, S72.92XQ, S72.92XR, S72.92XS

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
    Unspecified fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC 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.

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. 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
  3. 2 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  4. 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 S72.92XF 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):INJ042 — Fracture of lower limb (except 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.

S72.90XF — Unspecified fracture of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing (unspecified)Compare S72.92XF vs S72.90XF →, S72.91XF — Unspecified fracture of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing (right)Compare S72.92XF vs S72.91XF →

Same injury, other encounter phase

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

S72.92XA — Unspecified fracture of left femur, initial encounter for closed fractureCompare S72.92XF vs S72.92XA →, S72.92XB — Unspecified fracture of left femur, initial encounter for open fracture type I or II, S72.92XC — Unspecified fracture of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC, S72.92XD — Unspecified fracture of left femur, subsequent encounter for closed fracture with routine healing, S72.92XE — Unspecified fracture of left femur, subsequent encounter for open fracture type I or II with routine healing, S72.92XG — Unspecified fracture of left femur, subsequent encounter for closed fracture with delayed healing, S72.92XH — Unspecified fracture of left femur, subsequent encounter for open fracture type I or II with delayed healing, S72.92XJ — Unspecified fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing, S72.92XK — Unspecified fracture of left femur, subsequent encounter for closed fracture with nonunion, S72.92XM — Unspecified fracture of left femur, subsequent encounter for open fracture type I or II with nonunion, S72.92XN — Unspecified fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion, S72.92XP — Unspecified fracture of left femur, subsequent encounter for closed fracture with malunion, S72.92XQ — Unspecified fracture of left femur, subsequent encounter for open fracture type I or II with malunion, S72.92XR — Unspecified fracture of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion, S72.92XS — Unspecified fracture of left femur, sequela

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Fracture of lower limb (except hip), subsequent encounter).

+4697 more

Contextual Map

Every relationship of S72.92XF 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)

MS-DRG Grouper

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 S72.92XF 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 S72.92XF in its code family, with their registry titles.

View all codes in the S72 family