ICDcodes.org
FY2027

S72.133QDisplaced apophyseal fracture of unspecified femur, subsequent encounter for open fracture type I or II with malunion

BillableUnspecifiedCC

Is S72.133Q billable?

Yes, but S72.133Q will trip a Medicare edit. S72.133Q is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S72.133Q under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.

S72.133Q at a glance

CodeS72.133Q
DescriptionDisplaced apophyseal fracture of unspecified femur, subsequent encounter for open fracture type I or II with malunion
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027
7th character "Q"subsequent encounter for open fracture type I or II with malunion

What does the 7th character "Q" mean in S72.133Q?

In S72.133Q, the 7th character Q means subsequent encounter for open fracture type I or II with malunion. The 7th character is required for S72.133Q to be a valid, complete code.

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

What Medicare edits apply to S72.133Q?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S72.133Q directly.

Unspecified — a laterality-specific code exists — MCE edit 20

A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.

Which MS-DRGs does S72.133Q group to?

S72.133Q 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, S72.133Q is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is S72.133Q listed in the Alphabetic Index?

The Alphabetic Index lists these routes under S72.13, the nearest indexed parent of S72.133Q. Use them to find the family, then select the specific code.

  • Fracture, traumaticfemur, femoraltrochantericapophyseal (abduction) (adduction) (separation)
  • Fracture, traumaticfemur, femoralupper endapophyseal (abduction) (adduction) (separation)
  • Fracture, traumaticfemur, femoraltrochantericapophysealnondisplaced (abduction) (adduction) (separation)
  • Fracture, traumaticfemur, femoralupper endapophysealnondisplaced (abduction) (adduction) (separation)

Excludes1 — never code together — inherited from S72

The conditions below can never be reported together with S72.133Q 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.-)

Excludes1 — never code together — inherited from S72.13

The conditions below can never be reported together with S72.133Q on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • chronic (nontraumatic) slipped upper femoral epiphysis (M93.0-)

Use additional code — inherited from Chapter 19

Report an additional code alongside S72.133Q to fully describe the condition. S72.133Q 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 S72.133Q, but a patient may have both at the same time. When documentation supports it, S72.133Q 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 S72.133Q, but a patient may have both at the same time. When documentation supports it, S72.133Q 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 S72.133Q, but a patient may have both at the same time. When documentation supports it, S72.133Q 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-)

How long has S72.133Q existed?

S72.133Q 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.