ICDcodes.org
FY2027

S72.8X9POther fracture of unspecified femur, subsequent encounter for closed fracture with malunion

BillableUnspecifiedCC

Is S72.8X9P billable?

Yes, but S72.8X9P will trip a Medicare edit. S72.8X9P is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S72.8X9P 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.

S72.8X9P at a glance

CodeS72.8X9P
DescriptionOther fracture of unspecified femur, subsequent encounter for closed fracture with malunion
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027
7th character "P"subsequent encounter for closed fracture with malunion

What does the 7th character "P" mean in S72.8X9P?

In S72.8X9P, the 7th character P means subsequent encounter for closed fracture with malunion. The 7th character is required for S72.8X9P to be a valid, complete code.

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

What Medicare edits apply to S72.8X9P?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S72.8X9P 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 S72.8X9P group to?

S72.8X9P 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, S72.8X9P is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

Excludes1 — never code together — inherited from S72

The conditions below can never be reported together with S72.8X9P 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 S72.8X9P to fully describe the condition. S72.8X9P 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 S72.8X9P, but a patient may have both at the same time. When documentation supports it, S72.8X9P 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 S72.8X9P, but a patient may have both at the same time. When documentation supports it, S72.8X9P 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 S72.8X9P, but a patient may have both at the same time. When documentation supports it, S72.8X9P 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 S72.8X9P existed?

S72.8X9P 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.