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S72.364K ICD-10-CM Code: Nondisplaced segmental fracture of shaft of right femur, subsequent encounter for closed fracture with nonunion

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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)

S72.364K

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

Nondisplaced segmental fracture of shaft of right femur, subsequent encounter for closed fracture with nonunion

Nondisplaced segmental fracture of shaft of right femur, subsequent encounter for closed fracture with nonunion

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
S72.36Segmental fracture of shaft of femur
S72.364Nondisplaced segmental fracture of shaft of right femur
S72.364KNondisplaced segmental fracture of shaft of right femur, subsequent encounter for closed fracture with nonunion

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for S72.364K in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for S72.364K in this effective period.

Related Child Codes

Official
S72.364ANondisplaced segmental fracture of shaft of right femur, initial encounter for closed fracture
S72.364BNondisplaced segmental fracture of shaft of right femur, initial encounter for open fracture type I or II
S72.364CNondisplaced segmental fracture of shaft of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
S72.364DNondisplaced segmental fracture of shaft of right femur, subsequent encounter for closed fracture with routine healing
S72.364ENondisplaced segmental fracture of shaft of right femur, subsequent encounter for open fracture type I or II with routine healing

Includes

Official

ICD-10-CM does not list Includes notes for S72.364K in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for S72.364K in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for S72.364K in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for S72.364K in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for S72.364K 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 S72.364K an HCC code?

No. S72.364K is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

S72.364K is the ICD-10-CM diagnosis code for nondisplaced segmental fracture of shaft of right femur, subsequent encounter for closed fracture with nonunion. S72.364K 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).

S72.364K is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

S72.364K is a billable ICD-10-CM code that can be reported on claims but does not currently contribute to a Medicare Advantage member's RAF score under any CMS risk adjustment model (V28, V24, ESRD, or RxHCC). Coders reviewing S72.364K should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for S72.364K sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

S72.364ANondisplaced segmental fracture of shaft of right femur, initial encounter for closed fracture
HCC 402
S72.364BNondisplaced segmental fracture of shaft of right femur, initial encounter for open fracture type I or II
HCC 402
S72.364CNondisplaced segmental fracture of shaft of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC
HCC 402
S72.364DNondisplaced segmental fracture of shaft of right femur, subsequent encounter for closed fracture with routine healing
S72.364ENondisplaced segmental fracture of shaft of right femur, subsequent encounter for open fracture type I or II with routine healing
S72.364FNondisplaced segmental fracture of shaft of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
S72.364GNondisplaced segmental fracture of shaft of right femur, subsequent encounter for closed fracture with delayed healing
S72.364HNondisplaced segmental fracture of shaft of right femur, subsequent encounter for open fracture type I or II with delayed healing
S72.364JNondisplaced segmental fracture of shaft of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
S72.364KNondisplaced segmental fracture of shaft of right femur, subsequent encounter for closed fracture with nonunion
S72.364MNondisplaced segmental fracture of shaft of right femur, subsequent encounter for open fracture type I or II with nonunion
S72.364NNondisplaced segmental fracture of shaft of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
S72.364PNondisplaced segmental fracture of shaft of right femur, subsequent encounter for closed fracture with malunion
S72.364QNondisplaced segmental fracture of shaft of right femur, subsequent encounter for open fracture type I or II with malunion
S72.364RNondisplaced segmental fracture of shaft of right femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
S72.364SNondisplaced segmental fracture of shaft of right femur, sequela

Code Hierarchy

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