ICDcodes.org
FY2027

S72.011CUnspecified intracapsular fracture of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC

BillableUnspecifiedMCC

Is S72.011C billable?

Yes, but S72.011C is an unspecified code. S72.011C is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, S72.011C 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 S72.011C — the more specific alternatives are listed below.

S72.011C at a glance

CodeS72.011C
DescriptionUnspecified intracapsular fracture of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027
7th character "C"initial encounter for open fracture type IIIA, IIIB, or IIIC

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

In S72.011C, the 7th character C means initial encounter for open fracture type IIIA, IIIB, or IIIC. The 7th character is required for S72.011C to be a valid, complete code.

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

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

S72.011C 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, S72.011C 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 S72.011C listed in the Alphabetic Index?

The Alphabetic Index lists these routes under S72.01, the nearest indexed parent of S72.011C. 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 S72.011C 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 S72.011C to fully describe the condition. S72.011C 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 S72.011C, but a patient may have both at the same time. When documentation supports it, S72.011C 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 S72.011C, but a patient may have both at the same time. When documentation supports it, S72.011C 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 S72.011C, but a patient may have both at the same time. When documentation supports it, S72.011C 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 S72.011C, but a patient may have both at the same time. When documentation supports it, S72.011C 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 S72.011C existed?

S72.011C 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.