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S72.90XA
ICD-10-CM
Hip Fracture

Find comprehensive information on hip fracture diagnosis, including clinical documentation, medical coding, and healthcare resources. Learn about ICD-10 codes for hip fractures, femoral neck fractures, intertrochanteric fractures, and related complications. This resource covers proper documentation for hip fracture diagnosis, treatment, and aftercare, essential for accurate medical coding and billing. Explore relevant healthcare guidelines for managing hip fractures and ensuring optimal patient outcomes.

Also known as

Femoral Neck Fracture
Intertrochanteric Fracture
Subtrochanteric Fracture
+3 more

Diagnosis Snapshot

Key Facts
  • Definition : A break in the upper quarter of the femur bone.
  • Clinical Signs : Inability to bear weight, severe hip/groin pain, shortened/externally rotated leg.
  • Common Settings : Trauma, falls, osteoporosis related fragility fractures.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC S72.90XA Coding
S72.0-S72.9

Fracture of neck of femur

Fractures involving the neck of the femur bone.

S72.10-S72.19

Pertrochanteric fracture

Fractures in the trochanteric region of the femur.

S72.2-S72.29

Subtrochanteric fracture

Fractures located below the trochanters 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?

  • Yes

    Site specified?

  • No

    Pathological fracture?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Hip Fracture
Femoral Neck Fracture
Intertrochanteric Fracture

Documentation Best Practices

Documentation Checklist
  • Hip fracture diagnosis documentation checklist
  • ICD-10 code for hip fracture (e.g., S72.001A)
  • Anatomical site (e.g., femoral neck, intertrochanteric)
  • Fracture type (e.g., displaced, comminuted, impacted)
  • Mechanism of injury (e.g., fall, trauma)
  • Associated injuries (if any)

Coding and Audit Risks

Common Risks
  • Laterality Documentation

    Missing or unclear documentation of right, left, or bilateral hip fracture impacts accurate ICD-10 and CPT coding for reimbursement.

  • Fracture Type Specificity

    Lack of detail specifying closed, open, displaced, or other fracture characteristics leads to coding errors and potential claim denials.

  • Associated Injury Coding

    Failure to capture and code associated injuries like head trauma or other fractures with the hip fracture complicates risk adjustment and DRG assignment.

Mitigation Tips

Best Practices
  • Document fracture type, location, displacement for accurate ICD-10 coding (S72.-)
  • Capture laterality (left/right) and any associated injuries for optimal reimbursement.
  • Query physician for clarity if documentation lacks detail impacting DRG assignment.
  • Ensure clinical indicators support medical necessity for procedures like ORIF/THA.
  • Timely and accurate coding prevents denials, improves CDI, and ensures compliance.

Clinical Decision Support

Checklist
  • 1. Verify mechanism of injury: fall or trauma documented.
  • 2. Confirm imaging: X-ray/CT/MRI showing fracture.
  • 3. Assess pain location: groin, hip, thigh or buttock.
  • 4. Evaluate mobility: limited weight-bearing/rotation.
  • 5. Document affected side: right or left hip fracture.

Reimbursement and Quality Metrics

Impact Summary
  • Hip Fracture Reimbursement: Coding accuracy impacts MS-DRG assignment (e.g., 540, 541) affecting hospital payments. Proper documentation of fracture type, displacement, and treatment is crucial for optimal reimbursement.
  • Quality Metrics Impact: Hip Fracture complications like surgical site infections or DVT affect hospital quality reporting and value-based purchasing programs.
  • Coding Accuracy for Hip Fracture: Accurate ICD-10-CM (e.g., S72.0) and CPT (e.g., 27244) coding ensures appropriate reimbursement and accurate hospital data reporting.
  • Hospital Reporting: Hip Fracture data impacts publicly reported quality measures like time to surgery and readmission rates, influencing hospital reputation and patient choice.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code fracture site, laterality
  • Document displacement type
  • ICD-10 S72, M80 for pathfracture
  • Query physician for unclear documentation
  • Specificity improves coding accuracy

Documentation Templates

Patient presents with complaints consistent with hip fracture.  Onset of symptoms occurred on [Date of onset] following a [Mechanism of injury: e.g., fall from standing height, low-impact trauma, twisting injury].  Patient reports severe pain in the [Location: e.g., right hip, left hip, groin] radiating to the [Radiation: e.g., thigh, buttock, lower back].  Pain is exacerbated by movement and weight-bearing.  Patient exhibits [Symptoms: e.g., antalgic gait, inability to bear weight, shortening of the affected limb, external rotation of the affected leg].  Physical examination reveals [Findings: e.g., tenderness to palpation over the greater trochanter, limited range of motion in the hip joint, ecchymosis].  Differential diagnosis includes hip dislocation, femoral neck stress fracture, avulsion fracture, and trochanteric bursitis.  Preliminary diagnosis of hip fracture is suspected.  Ordered imaging studies including [Imaging ordered: e.g., X-ray of the hip, CT scan, MRI] to confirm the diagnosis and determine the specific fracture type (e.g., intertrochanteric fracture, femoral neck fracture, subtrochanteric fracture).  Treatment plan pending imaging results may include pain management with analgesics, surgical intervention (e.g., open reduction internal fixation ORIF, hip replacement surgery), or conservative management with traction and immobilization.  Patient education provided regarding fall prevention, bone health, and potential complications of hip fractures such as avascular necrosis and nonunion.  Follow-up appointment scheduled for [Date of follow-up] to discuss imaging results and finalize treatment plan.  ICD-10 code S72.  Procedure codes pending treatment decision.