Excludes1 pair
S72- vs S72.9-
S72 and S72.9 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
S72
Fracture of femur
Not billable
- Chapter 19
- Injury, poisoning and certain other consequences of external causes
- Section
- S70-S79
S72.9
Unspecified fracture of femur
Not billable
- Chapter 19
- Injury, poisoning and certain other consequences of external causes
- Section
- S70-S79
Use when the record says
- Fracture of thigh NOS
- Fracture of upper leg NOS
Indexed under
- Fracture, traumatic › femur, femoral
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027