ICDcodes.org
FY2027

S72.011AUnspecified intracapsular fracture of right femur, initial encounter for closed fracture

BillableUnspecifiedMCC

Is S72.011A billable?

Yes, but S72.011A is an unspecified code. S72.011A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, S72.011A is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting S72.011A — the more specific alternatives are listed below.

S72.011A at a glance

CodeS72.011A
DescriptionUnspecified intracapsular fracture of right femur, initial encounter for closed fracture
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027
7th character "A"initial encounter for closed fracture

What does the 7th character "A" mean in S72.011A?

In S72.011A, the 7th character A means initial encounter for closed fracture. The 7th character is required for S72.011A to be a valid, complete code.

Same condition, different episode of care — switch the 7th character:

Which MS-DRGs does S72.011A group to?

S72.011A sits in MDC 08 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 521Hip Replacement with Principal Diagnosis of Hip Fracture with MCCsurgical
  • 522Hip Replacement with Principal Diagnosis of Hip Fracture without MCCsurgical

As a secondary diagnosis, S72.011A is a major complication or comorbidity (MCC), which can move a stay into a higher-paying DRG. It also carries Hospital-Acquired Condition category 05.

How is S72.011A listed in the Alphabetic Index?

The Alphabetic Index lists these routes under S72.01, the nearest indexed parent of S72.011A. Use them to find the family, then select the specific code.

  • Fracture, traumaticfemur, femoralsubcapital (abduction) (adduction) (separation)
  • Fracture, traumaticfemur, femoralupper endintracapsular (abduction) (adduction) (separation)
  • Fracture, traumaticfemur, femoralupper endsubcapital (abduction) (adduction) (separation)

Excludes1 — never code together — inherited from S72

The conditions below can never be reported together with S72.011A on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • traumatic amputation of hip and thigh (S78.-)

Use additional code — inherited from Chapter 19

Report an additional code alongside S72.011A to fully describe the condition. S72.011A is sequenced first.

  • code to identify any retained foreign body, if applicable (Z18.-)

Excludes2 — not included here — inherited from Chapter 19

The conditions below are not part of S72.011A, but a patient may have both at the same time. When documentation supports it, S72.011A and the excluded code may both be reported.

  • birth trauma (P10-P15)
  • obstetric trauma (O70-O71)

Excludes2 — not included here — inherited from S70-S79

The conditions below are not part of S72.011A, but a patient may have both at the same time. When documentation supports it, S72.011A and the excluded code may both be reported.

  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • snake bite (T63.0-)
  • venomous insect bite or sting (T63.4-)

Excludes2 — not included here — inherited from S72

The conditions below are not part of S72.011A, but a patient may have both at the same time. When documentation supports it, S72.011A and the excluded code may both be reported.

  • fracture of lower leg and ankle (S82.-)
  • fracture of foot (S92.-)
  • periprosthetic fracture of prosthetic implant of hip (M97.0-)

Excludes2 — not included here — inherited from S72.0

The conditions below are not part of S72.011A, but a patient may have both at the same time. When documentation supports it, S72.011A and the excluded code may both be reported.

  • physeal fracture of lower end of femur (S79.1-)
  • physeal fracture of upper end of femur (S79.0-)

How long has S72.011A existed?

S72.011A has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.