S79.199K — Other physeal fracture of lower end of unspecified femur, subsequent encounter for fracture with nonunion
Is S79.199K billable?
Yes, but S79.199K will trip a Medicare edit. S79.199K is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S79.199K 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.
S79.199K at a glance
| Code | S79.199K |
|---|---|
| Description | Other physeal fracture of lower end of unspecified femur, subsequent encounter for fracture with nonunion |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "K" | subsequent encounter for fracture with nonunion |
What does the 7th character "K" mean in S79.199K?
In S79.199K, the 7th character K means subsequent encounter for fracture with nonunion. The 7th character is required for S79.199K to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
- Ainitial encounter for closed fractureS79.199A
- Dsubsequent encounter for fracture with routine healingS79.199D
- Gsubsequent encounter for fracture with delayed healingS79.199G
- Ksubsequent encounter for fracture with nonunionS79.199K
- Psubsequent encounter for fracture with malunionS79.199P
- SsequelaS79.199S
What Medicare edits apply to S79.199K?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S79.199K 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 S79.199K group to?
S79.199K 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, S79.199K is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is S79.199K listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S79.19, the nearest indexed parent of S79.199K. Use them to find the family, then select the specific code.
- Fracture, traumatic › femur, femoral › lower end › physeal › specified NEC (abduction) (adduction) (separation)
Use additional code — inherited from Chapter 19
Report an additional code alongside S79.199K to fully describe the condition. S79.199K 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 S79.199K, but a patient may have both at the same time. When documentation supports it, S79.199K and the excluded code may both be reported.
Excludes2 — not included here — inherited from S70-S79
The conditions below are not part of S79.199K, but a patient may have both at the same time. When documentation supports it, S79.199K and the excluded code may both be reported.
How long has S79.199K existed?
S79.199K 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.