Find information on Subcapital Femoral Neck Fracture diagnosis, including clinical documentation tips, ICD-10-CM code S72.031A, medical coding guidelines, and healthcare resources. Learn about femoral neck fracture treatment, prognosis, and complications. This resource provides essential information for physicians, coders, and other healthcare professionals dealing with subcapital femoral neck fractures. Explore relevant information on fracture classification, Garden classification, displaced femoral neck fracture, and non-displaced femoral neck fracture for accurate diagnosis and coding.
Also known as
Fracture of neck of femur
This code range covers fractures of the femoral neck, including subcapital fractures.
Fracture of femur
Encompasses all femoral fractures, including those at the neck and other locations.
Injury, poisoning and certain other consequences of external causes
Broad category including various injuries, including fractures from trauma.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the fracture traumatic?
Yes
Displaced fracture?
No
Pathological fracture?
When to use each related code
| Description |
|---|
| Subcapital Femoral Neck Fx |
| Transcervical Femoral Neck Fx |
| Intertrochanteric Femoral Fx |
Missing or incorrect laterality (right, left, unspecified) for subcapital femoral neck fracture can lead to claim rejections and inaccurate data.
Failure to distinguish between displaced and nondisplaced fractures (e.g., using S72.00- vs. S72.01-) affects severity and reimbursement.
Overlooking or undercoding associated injuries (e.g., other fractures, soft tissue damage) impacts patient care quality indicators.
Q: What are the key clinical findings and imaging characteristics that differentiate a subcapital femoral neck fracture from an intertrochanteric fracture in elderly patients?
A: Differentiating a subcapital femoral neck fracture from an intertrochanteric fracture is crucial for determining appropriate management. Subcapital fractures occur just below the femoral head, often presenting with groin pain, shortened and externally rotated leg, and limited hip range of motion. Imaging, particularly radiographs, reveals a fracture line through the femoral neck inferior to the head. Intertrochanteric fractures, however, occur between the greater and lesser trochanters, exhibiting similar clinical signs but with a more obvious deformity. Radiographs will show a fracture line between the trochanters. While both fractures are common in elderly patients with osteoporosis, subtle differences in location and radiographic findings help in the diagnosis. Delayed diagnosis can lead to avascular necrosis of the femoral head in subcapital fractures, emphasizing the need for prompt and accurate assessment. Explore how advanced imaging modalities like CT or MRI can further clarify the fracture type and aid in surgical planning.
Q: How do I choose the best surgical approach for a subcapital femoral neck fracture based on Garden classification and patient factors like age and bone quality?
A: The optimal surgical approach for a subcapital femoral neck fracture is determined by a combination of Garden classification and patient-specific factors. For Garden I and II fractures (undisplaced or incomplete), internal fixation with cannulated screws or a sliding hip screw is often preferred, aiming to preserve the femoral head. In older patients with osteoporotic bone, however, the stability of fixation might be compromised. Garden III and IV fractures (completely displaced) pose a higher risk of nonunion and avascular necrosis. In younger patients, reduction and internal fixation may be attempted, but arthroplasty, either total hip replacement or hemiarthroplasty, is often the preferred treatment in elderly patients with displaced fractures or those with significant pre-existing osteoarthritis. Patient age, bone quality, and functional demands play a crucial role in decision-making. Consider implementing a multidisciplinary approach involving orthogeriatric input to tailor treatment strategies for individual patient needs.
Patient presents with complaints of severe hip pain following a low-energy fall (or mechanism of injury if high-energy, specify e.g., motor vehicle accident). Physical examination reveals tenderness to palpation over the hip joint, limited range of motion, and pain exacerbated by internal and external rotation. Ecchymosis and swelling may be present. The patient is unable to bear weight. Radiographic imaging (X-ray, hip series) demonstrates a subcapital fracture of the femoral neck, classified as Garden [I, II, III, or IV - specify based on displacement] (or Pauwels [I, II, or III - specify based on angle]). Differential diagnosis includes intertrochanteric fracture, femoral neck stress fracture, and avulsion fracture. Diagnosis of subcapital femoral neck fracture confirmed. Treatment plan includes pain management with analgesics, possible closed reduction if indicated, and surgical intervention likely required. Surgical options include open reduction internal fixation (ORIF) with cannulated screws or dynamic hip screw (DHS), hemiarthroplasty, or total hip arthroplasty (THA) depending on patient age, bone quality, and fracture displacement. Risks and benefits of each procedure discussed with the patient. Follow-up scheduled with orthopedics for definitive surgical management and post-operative care. ICD-10 code S72.031A (for initial encounter for closed subcapital fracture, right hip) or appropriate laterality and open vs. closed fracture codes used. CPT codes for procedures performed will be documented post-operatively. Patient education provided regarding fall prevention strategies, post-operative rehabilitation, and potential complications including avascular necrosis, nonunion, and infection.