S79.109A — Unspecified physeal fracture of lower end of unspecified femur, initial encounter for closed fracture
Is S79.109A billable?
Yes, but S79.109A will trip a Medicare edit. S79.109A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S79.109A 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.
More specific alternatives
- S79.111ASalter-Harris Type I physeal fracture of lower end of right femur, initial encounter for closed fracture
- S79.121ASalter-Harris Type II physeal fracture of lower end of right femur, initial encounter for closed fracture
- S79.131ASalter-Harris Type III physeal fracture of lower end of right femur, initial encounter for closed fracture
- S79.141ASalter-Harris Type IV physeal fracture of lower end of right femur, initial encounter for closed fracture
- S79.191AOther physeal fracture of lower end of right femur, initial encounter for closed fracture
S79.109A at a glance
| Code | S79.109A |
|---|---|
| Description | Unspecified physeal fracture of lower end of unspecified femur, initial encounter for closed fracture |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter for closed fracture |
What does the 7th character "A" mean in S79.109A?
In S79.109A, the 7th character A means initial encounter for closed fracture. The 7th character is required for S79.109A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
- Ainitial encounter for closed fractureS79.109A
- Dsubsequent encounter for fracture with routine healingS79.109D
- Gsubsequent encounter for fracture with delayed healingS79.109G
- Ksubsequent encounter for fracture with nonunionS79.109K
- Psubsequent encounter for fracture with malunionS79.109P
- SsequelaS79.109S
What Medicare edits apply to S79.109A?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S79.109A directly.
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 S79.109A group to?
S79.109A 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.
- 533Fractures of Femur with MCCmedical
- 534Fractures of Femur without MCCmedical
As a secondary diagnosis, S79.109A is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG. It also carries Hospital-Acquired Condition category 05.
How is S79.109A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S79.10, the nearest indexed parent of S79.109A. Use them to find the family, then select the specific code.
- Fracture, traumatic › femur, femoral › lower end › physeal (abduction) (adduction) (separation)
Use additional code — inherited from Chapter 19
Report an additional code alongside S79.109A to fully describe the condition. S79.109A 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 S79.109A, but a patient may have both at the same time. When documentation supports it, S79.109A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S70-S79
The conditions below are not part of S79.109A, but a patient may have both at the same time. When documentation supports it, S79.109A and the excluded code may both be reported.
How long has S79.109A existed?
S79.109A 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.