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S72.045A ICD-10-CM Code: Nondisplaced fracture of base of neck of left femur, initial encounter for closed fracture

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FY 2026 Apr update / Injury, poisoning and certain other consequences of external causes (S00-T88) / Injuries to the hip and thigh (S70-S79)

S72.045A

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Nondisplaced fracture of base of neck of left femur, initial encounter for closed fracture

Nondisplaced fracture of base of neck of left femur, initial encounter for closed fracture

CMS-HCC V28

HCC 402

RAF 0.0

CMS-HCC V24

HCC 170

RAF 0.451

ACA/HHS

0

0

RAF 0

ESRD/PACE

HCC 170

RAF 0.0

RXHCC

0

0

RAF 0

Code Trumping

Basket needed

Code Book Path

Official
S72.04Fracture of base of neck of femur
S72.045Nondisplaced fracture of base of neck of left femur
S72.045ANondisplaced fracture of base of neck of left femur, initial encounter for closed fracture

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for S72.045A in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for S72.045A in this effective period.

Related Child Codes

Official
S72.045BNondisplaced fracture of base of neck of left femur, initial encounter for open fracture type I or II
S72.045CNondisplaced fracture of base of neck of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
S72.045DNondisplaced fracture of base of neck of left femur, subsequent encounter for closed fracture with routine healing
S72.045ENondisplaced fracture of base of neck of left femur, subsequent encounter for open fracture type I or II with routine healing
S72.045FNondisplaced fracture of base of neck of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing

Includes

Official

ICD-10-CM does not list Includes notes for S72.045A in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for S72.045A in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for S72.045A in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for S72.045A in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for S72.045A in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is S72.045A an HCC code?

Yes. S72.045A maps to Pathological Fractures under the CMS-HCC V28 risk adjustment model (and Hip Fracture/Dislocation under V24).

HCC Category Mapping

V28HCC 402, Pathological Fractures
0.000
V24HCC 170, Hip Fracture/Dislocation
0.451
ESRDHCC 170, Hip Fracture/Dislocation
0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

MEAT Criteria for S72.045A

For S72.045Ato count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

  • MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
  • EEvaluate: test results, medication response, or physical findings reviewed by the provider
  • AAssess: explicit mention in the assessment or plan with acknowledgment of status
  • TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed S72.045A during that encounter, not just copy-forwarded from a problem list.

What This Code Means

S72.045A is the ICD-10-CM diagnosis code for nondisplaced fracture of base of neck of left femur, initial encounter for closed fracture. S72.045A sits in the ICD-10-CM chapter for injury, poisoning and certain other consequences of external causes (s00-t88), within the section covering injuries to the hip and thigh (s70-s79).

Under the CMS-HCC V28 risk adjustment model, S72.045A maps to Pathological Fractures (HCC 402) with a community, non-dual, aged base RAF weight of 0.000. Under the older CMS-HCC V24 model, S72.045A maps to Hip Fracture/Dislocation (HCC 170) with a community, non-dual, aged base RAF weight of 0.451. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Coders should report S72.045A only when the provider documentation supports the specific condition described, since more specific codes within the same hierarchy can capture additional clinical detail and may carry a higher RAF weight. Because S72.045A maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for S72.045A sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

S72.045ANondisplaced fracture of base of neck of left femur, initial encounter for closed fracture
HCC 402
S72.045BNondisplaced fracture of base of neck of left femur, initial encounter for open fracture type I or II
HCC 402
S72.045CNondisplaced fracture of base of neck of left femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
HCC 402
S72.045DNondisplaced fracture of base of neck of left femur, subsequent encounter for closed fracture with routine healing
S72.045ENondisplaced fracture of base of neck of left femur, subsequent encounter for open fracture type I or II with routine healing
S72.045FNondisplaced fracture of base of neck of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
S72.045GNondisplaced fracture of base of neck of left femur, subsequent encounter for closed fracture with delayed healing
S72.045HNondisplaced fracture of base of neck of left femur, subsequent encounter for open fracture type I or II with delayed healing
S72.045JNondisplaced fracture of base of neck of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
S72.045KNondisplaced fracture of base of neck of left femur, subsequent encounter for closed fracture with nonunion
S72.045MNondisplaced fracture of base of neck of left femur, subsequent encounter for open fracture type I or II with nonunion
S72.045NNondisplaced fracture of base of neck of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
S72.045PNondisplaced fracture of base of neck of left femur, subsequent encounter for closed fracture with malunion
S72.045QNondisplaced fracture of base of neck of left femur, subsequent encounter for open fracture type I or II with malunion
S72.045RNondisplaced fracture of base of neck of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
S72.045SNondisplaced fracture of base of neck of left femur, sequela

Code Hierarchy

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