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S72.90XA
ICD-10-CM
Broken Femur

Understanding Broken Femur (Femoral Fracture) diagnosis, treatment, and recovery? Find information on hip fracture types, femoral shaft fractures, clinical documentation requirements for accurate medical coding, and healthcare best practices. Learn about ICD-10 codes, CPT codes, and proper medical terminology associated with a fractured femur for optimized billing and documentation. Explore resources for patients and healthcare professionals regarding broken femur diagnosis and treatment options.

Also known as

Femoral Fracture
Hip Fracture

Diagnosis Snapshot

Key Facts
  • Definition : A break in the femur bone, commonly the upper part near the hip or the shaft.
  • Clinical Signs : Severe pain, swelling, inability to bear weight, deformity, bruising.
  • Common Settings : Trauma (falls, accidents), osteoporosis, high-impact sports.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC S72.90XA Coding
S72.-

Fracture of femur

This code range covers fractures of the femur, including the shaft, neck, and other parts.

S72.0-

Fracture of neck of femur

Specifies fractures specifically at the neck of the femur.

S72.1-

Pertrochanteric fracture

Fractures involving the trochanteric region of the femur.

S72.2-

Subtrochanteric fracture

Fractures occurring in the subtrochanteric area of the femur.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the fracture traumatic?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Thigh bone break.
Proximal femur fracture.
Stress fracture in femur.

Documentation Best Practices

Documentation Checklist
  • Femur fracture type (e.g., spiral, comminuted)
  • Location of fracture (e.g., femoral neck, shaft)
  • Mechanism of injury (e.g., fall, trauma)
  • Radiographic findings confirming fracture
  • Associated injuries documented

Coding and Audit Risks

Common Risks
  • Specificity of Fracture

    Coding requires specifying location (e.g., proximal, shaft, distal) and type (e.g., displaced, comminuted). Imprecise documentation leads to coding errors.

  • Laterality Documentation

    Missing laterality (left, right, bilateral) impacts coding accuracy and reimbursement. Clear documentation is crucial for proper coding.

  • Traumatic vs. Pathologic

    Distinguishing between traumatic and pathologic fractures is essential. Unspecified etiology affects coding, severity, and clinical pathway selection.

Mitigation Tips

Best Practices
  • ICD-10 S72, accurate fracture site documentation for proper coding.
  • Fall risk assessment, implement preventative measures, document in EHR.
  • Timely pain management, optimize analgesia, monitor, document effectiveness.
  • Orthopedic consult, prompt surgical intervention, optimize fracture healing.
  • PT/OT referral, early mobilization, improve functional outcomes, track progress.

Clinical Decision Support

Checklist
  • Confirm trauma mechanism or osteoporosis risk (ICD-10 S72, M80).
  • Physical exam: Assess pain, deformity, mobility (CPT 99214).
  • Order X-ray imaging of femur (CPT 73500, 73510) for diagnosis.
  • Evaluate neurovascular status of the leg for complications.

Reimbursement and Quality Metrics

Impact Summary
  • Diagnosis: Broken Femur (B), Femoral Fracture, Hip Fracture impacts reimbursement through accurate medical coding and proper ICD-10 application for optimal claim processing.
  • Coding accuracy for Broken Femur (ICD-10 S72) directly impacts hospital reporting quality metrics on fracture care and patient outcomes.
  • Accurate Femoral Fracture diagnosis coding ensures appropriate DRG assignment and impacts hospital reimbursement levels and financial performance.
  • Hip Fracture coding quality affects publicly reported hospital quality data, impacting patient choices and hospital ratings.

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Frequently Asked Questions

Common Questions and Answers

Q: What are the key differentiating factors in diagnosing a femoral shaft fracture versus a hip fracture, considering both often present with similar symptoms?

A: While both femoral shaft fractures and hip fractures can present with pain, swelling, and limited mobility in the thigh/hip region, differentiating them is crucial for proper management. A femoral shaft fracture, also known as a mid-shaft femur fracture, involves a break in the long bone of the thigh, the femur, between the hip and the knee. Hip fractures, specifically femoral neck or intertrochanteric fractures, involve a break in the proximal femur, the part of the femur closest to the hip joint. Physical examination findings such as leg shortening and external rotation are more common in femoral shaft fractures. Precise localization of tenderness and assessment of hip stability are essential. Radiographic imaging, including AP and lateral views of the hip and femur, is crucial for definitive diagnosis. Explore how advanced imaging modalities like CT or MRI can further delineate fracture patterns and assist in surgical planning for complex cases. Consider implementing standardized imaging protocols for suspected hip and femoral fractures to ensure accurate and timely diagnosis.

Q: How do I best manage acute pain in a patient presenting with a suspected or confirmed broken femur, especially considering the need for rapid stabilization and potential surgical intervention?

A: Effective acute pain management for a suspected or confirmed broken femur requires a multimodal approach. Initial stabilization of the fracture with appropriate splinting or traction is crucial to reduce pain and prevent further injury. Systemic analgesics, such as opioids and NSAIDs, are often necessary to provide adequate pain relief. Regional anesthesia, including femoral nerve blocks or fascia iliaca blocks, can offer effective pain control while minimizing systemic opioid use. Consider implementing pain management protocols that incorporate regular pain assessments, patient-controlled analgesia (PCA), and multimodal analgesia strategies. Learn more about the role of interventional pain management techniques in complex femur fractures. Remember to carefully monitor for potential complications of pain management, including respiratory depression and opioid-induced constipation.

Quick Tips

Practical Coding Tips
  • Code femur fracture, not hip
  • Specify fracture location
  • Document mechanism of injury
  • Query physician for laterality
  • Check for associated injuries

Documentation Templates

Patient presents with complaints consistent with a broken femur, also known as a femoral fracture or hip fracture.  Onset of symptoms occurred on [Date of onset] following [Mechanism of injury, e.g., a fall from standing height, motor vehicle accident].  Patient reports [Character of pain, e.g., severe, sharp, throbbing] pain in the [Location of pain, e.g., upper thigh, hip, groin] region, exacerbated by movement and weight-bearing.  Physical examination reveals [Physical exam findings, e.g., tenderness to palpation, edema, ecchymosis, deformity, limited range of motion] in the affected area.  Neurovascular assessment of the extremity demonstrates [Neurovascular status, e.g., intact distal pulses, normal sensation, capillary refill less than 2 seconds].  Differential diagnosis includes stress fracture, avulsion fracture, and pathological fracture.  Radiographic imaging (X-ray of the femur and hip) was ordered to confirm the diagnosis and assess the fracture type and location.  Preliminary imaging findings suggest a [Fracture type, e.g., transverse, oblique, comminuted] fracture of the [Location of fracture, e.g., femoral neck, femoral shaft, intertrochanteric region].  Treatment plan includes [Treatment plan, e.g., pain management with analgesics, orthopedic consultation for surgical intervention such as open reduction internal fixation (ORIF) or intramedullary nailing, immobilization with a brace or cast, physical therapy for rehabilitation].  Patient education provided on fracture care, weight-bearing restrictions, and follow-up appointments.  ICD-10 code [Appropriate ICD-10 code, e.g., S72.xxx] is being considered, pending final diagnosis and treatment plan.  CPT codes for procedures will be assigned upon completion of those services.  Prognosis for healing is dependent on fracture severity and patient compliance with treatment recommendations.
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