S72.401M — Unspecified fracture of lower end of right femur, subsequent encounter for open fracture type I or II with nonunion
Is S72.401M billable?
Yes, but S72.401M is an unspecified code. S72.401M is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, S72.401M 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 S72.401M — the more specific alternatives are listed below.
More specific alternatives
- S72.421MDisplaced fracture of lateral condyle of right femur, subsequent encounter for open fracture type I or II with nonunion
- S72.431MDisplaced fracture of medial condyle of right femur, subsequent encounter for open fracture type I or II with nonunion
- S72.441MDisplaced fracture of lower epiphysis (separation) of right femur, subsequent encounter for open fracture type I or II with nonunion
- S72.451MDisplaced supracondylar fracture without intracondylar extension of lower end of right femur, subsequent encounter for open fracture type I or II with nonunion
- S72.461MDisplaced supracondylar fracture with intracondylar extension of lower end of right femur, subsequent encounter for open fracture type I or II with nonunion
- S72.491MOther fracture of lower end of right femur, subsequent encounter for open fracture type I or II with nonunion
S72.401M at a glance
| Code | S72.401M |
|---|---|
| Description | Unspecified fracture of lower end of right femur, subsequent encounter for open fracture type I or II with nonunion |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "M" | subsequent encounter for open fracture type I or II with nonunion |
What does the 7th character "M" mean in S72.401M?
In S72.401M, the 7th character M means subsequent encounter for open fracture type I or II with nonunion. The 7th character is required for S72.401M to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
- Ainitial encounter for closed fractureS72.401A
- Binitial encounter for open fracture type I or IIS72.401B
- Cinitial encounter for open fracture type IIIA, IIIB, or IIICS72.401C
- Dsubsequent encounter for closed fracture with routine healingS72.401D
- Esubsequent encounter for open fracture type I or II with routine healingS72.401E
- Fsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healingS72.401F
- Gsubsequent encounter for closed fracture with delayed healingS72.401G
- Hsubsequent encounter for open fracture type I or II with delayed healingS72.401H
- Jsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healingS72.401J
- Ksubsequent encounter for closed fracture with nonunionS72.401K
- Msubsequent encounter for open fracture type I or II with nonunionS72.401M
- Nsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunionS72.401N
- Psubsequent encounter for closed fracture with malunionS72.401P
- Qsubsequent encounter for open fracture type I or II with malunionS72.401Q
- Rsubsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunionS72.401R
- SsequelaS72.401S
Which MS-DRGs does S72.401M group to?
S72.401M sits in MDC 08 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 564Other Musculoskeletal System and Connective Tissue Diagnoses with MCCmedical
- 565Other Musculoskeletal System and Connective Tissue Diagnoses with CCmedical
- 566Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCCmedical
As a secondary diagnosis, S72.401M is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is S72.401M listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S72.40, the nearest indexed parent of S72.401M. Use them to find the family, then select the specific code.
- Fracture, traumatic › femur, femoral › lower end (abduction) (adduction) (separation)
Excludes1 — never code together — inherited from S72
The conditions below can never be reported together with S72.401M 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 S72.401M to fully describe the condition. S72.401M 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 S72.401M, but a patient may have both at the same time. When documentation supports it, S72.401M and the excluded code may both be reported.
Excludes2 — not included here — inherited from S70-S79
The conditions below are not part of S72.401M, but a patient may have both at the same time. When documentation supports it, S72.401M and the excluded code may both be reported.
Excludes2 — not included here — inherited from S72
The conditions below are not part of S72.401M, but a patient may have both at the same time. When documentation supports it, S72.401M and the excluded code may both be reported.
Excludes2 — not included here — inherited from S72.4
The conditions below are not part of S72.401M, but a patient may have both at the same time. When documentation supports it, S72.401M and the excluded code may both be reported.
How long has S72.401M existed?
S72.401M 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.