S72.426B Nondisplaced fracture of lateral condyle of unspecified femur, initial encounter for open fracture type I or II

Billable ICD-10-CM code, FY2026.

Built from S72.426 with 7th character B (initial encounter for open fracture type I or II).

Applies from S72 Fracture of femur

Excludes1 (never code together)

• traumatic amputation of hip and thigh (S78.-)

Excludes2 (not included here)

• fracture of lower leg and ankle (S82.-)
• fracture of foot (S92.-)
• periprosthetic fracture of prosthetic implant of hip (M97.0-)

7th character note

• The appropriate 7th character is to be added to all codes from category S72

Notes

• A fracture not indicated as displaced or nondisplaced should be coded to displaced
• A fracture not indicated as open or closed should be coded to closed
• The open fracture designations are based on the Gustilo open fracture classification

7th character required

• A — initial encounter for closed fracture
• B — initial encounter for open fracture type I or II
• C — initial encounter for open fracture type IIIA, IIIB, or IIIC
• D — subsequent encounter for closed fracture with routine healing
• E — subsequent encounter for open fracture type I or II with routine healing
• F — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
• G — subsequent encounter for closed fracture with delayed healing
• H — subsequent encounter for open fracture type I or II with delayed healing
• J — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
• K — subsequent encounter for closed fracture with nonunion
• M — subsequent encounter for open fracture type I or II with nonunion
• N — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
• P — subsequent encounter for closed fracture with malunion
• Q — subsequent encounter for open fracture type I or II with malunion
• R — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
• S — sequela

Applies from S72.4 Fracture of lower end of femur

Applicable to

• Fracture of distal end of femur

Excludes2 (not included here)

• fracture of shaft of femur (S72.3-)
• physeal fracture of lower end of femur (S79.1-)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 402 — Hip Fracture/Dislocation
• CMS-HCC V22: HCC 170 — Hip Fracture/Dislocation
• ESRD V24: HCC 170

Medicare Code Edits (MCE v43.1 (April 2026))

• Unspecified code (laterality): Unspecified codes for which a more specific code identifying laterality (right, left, bilateral) exists within the same code family.

Code annotations containing back-references to S72.426B

Back-references to S72

• Type 1 Excludes: M84.3 Stress fracture ("traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)")
• Type 1 Excludes: M84.4 Pathological fracture, not elsewhere classified ("traumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-)")
• Type 1 Excludes: S71 Open wound of hip and thigh ("open fracture of hip and thigh (S72.-)")

Nearby codes

• S72.425Q Nondisplaced fracture of lateral condyle of left femur, subsequent encounter for open fracture type I or II with malunion
• S72.425R Nondisplaced fracture of lateral condyle of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
• S72.425S Nondisplaced fracture of lateral condyle of left femur, sequela
• S72.426 Nondisplaced fracture of lateral condyle of unspecified femur
• S72.426A Nondisplaced fracture of lateral condyle of unspecified femur, initial encounter for closed fracture
• S72.426B Nondisplaced fracture of lateral condyle of unspecified femur, initial encounter for open fracture type I or II (this code)
• S72.426C Nondisplaced fracture of lateral condyle of unspecified femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
• S72.426D Nondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for closed fracture with routine healing
• S72.426E Nondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for open fracture type I or II with routine healing
• S72.426F Nondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
• S72.426G Nondisplaced fracture of lateral condyle of unspecified femur, subsequent encounter for closed fracture with delayed healing