ICD-10 Code S72.414P: Right femur condyle fracture, malunion

Key takeaways

ICD-10 code S72.414P describes a nondisplaced unspecified condyle fracture of the lower end of the right femur, subsequent encounter for closed fracture with malunion

The 7th character P marks a follow-up visit for a closed fracture that has healed in the wrong position

Do not read M as malunion. In this subcategory M means an open type I or II fracture with nonunion, and the closed malunion code is P

Common coding error: leaving the initial encounter character A on follow-up visits, or swapping malunion (P) with nonunion (K), both of which trigger claim denials

Practice management software like Pabau helps orthopedic and physical therapy practices track encounter types and submit accurate ICD-10-CM codes across subsequent visits

ICD-10 code S72.414P covers a nondisplaced condyle fracture of the lower end of the right femur, seen on a subsequent encounter. Imaging has confirmed that the closed fracture healed in a mal-aligned position. The 7th character P is what records that outcome on the claim.

One trap deserves attention up front. In the S72.41x subcategory the letter M does not stand for malunion, so S72.414M is the wrong code here. This reference covers the full code description, the complete 7th character set, sibling codes, documentation requirements, and the errors coders make most often.

ICD-10 code S72.414P: Definition, billable status, and FY2026 validity

ICD-10 code S72.414P is a billable, specific ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) diagnosis code. It is valid for FY2026 HIPAA-covered transactions, so it can be submitted on healthcare claims for encounters in fiscal year 2026.

No further subdivision is needed. According to the CMS ICD-10 codes page, codes at this level of specificity are what compliant claim submission requires.

The full official description is: Nondisplaced unspecified condyle fracture of lower end of right femur, subsequent encounter for closed fracture with malunion. Every element of that description carries a coding implication. Get one wrong and the claim stops being a clean claim, so it comes back for correction instead of payment.

Breaking down the full code description

Each component of the S72.414P description encodes a distinct clinical fact. Understanding the anatomy and the ICD-10-CM nomenclature behind each part prevents the mismatch errors that generate the bulk of fracture code denials.

• Nondisplaced: The fracture fragments have not shifted out of anatomical alignment. Radiology or operative documentation must confirm this. Displacement status cannot be assumed from the code alone, so it must appear in the clinical record.
• Unspecified condyle: The condyle involved is not documented or is clinically indeterminate. When the record names the lateral condyle, the S72.42x codes apply instead. When it names the medial condyle, use the S72.43x codes.
• Lower end of femur: Also referred to as the distal femur, this is the region of the femur nearest the knee joint. It is distinct from the femoral neck and the femoral shaft.
• Right femur: Laterality is encoded at the code level. The left femur counterpart of this code is S72.415P. Document the affected side explicitly in every clinical note.
• Subsequent encounter: The patient is no longer in the acute phase of fracture treatment. Active treatment has concluded, and the patient is receiving routine care, evaluation, or management of a healing complication.
• Closed fracture: The skin overlying the fracture site was intact. An open fracture uses a different 7th character on the same base code, not a different base code.
• Malunion: The fracture has healed, but in a position of anatomical mal-alignment. This is distinct from nonunion, where healing has not occurred at all.

What the 7th character P means on a follow-up claim

On a follow-up claim, P means the closed fracture has healed in a mal-aligned position. That single character carries encounter type, fracture type, and healing status at once. For the S72.414 base code it decides whether the claim reads as an initial presentation, a routine follow-up, or a healing complication.

The CDC/NCHS ICD-10-CM web tool carries the official guidelines that govern the choice. Selecting the wrong character on a subsequent encounter is one of the leading causes of fracture code denials.

Insurers cross-reference encounter type against treatment history, so a claim for malunion management that still carries character A will trigger an edit.

Catching that mismatch before submission is the whole point of denial management. A held claim costs a minute of review, while a denied one costs a rework cycle and a delay in payment.

The characters run in triplets once healing status enters the picture. Each outcome gets one closed-fracture letter and two open-fracture letters. The order always runs closed first, then open type I or II, then the most severe open types.

Nonunion therefore takes K, M, and N, while malunion takes P, Q, and R as a set. That pattern is why M cannot mean closed fracture with malunion here, however much the letter suggests it. The final character S sits outside the triplets and marks a sequela, which is how S61.314S is built.

Malunion vs nonunion: Choosing the correct 7th character for S72.414P

Malunion means the bone healed in the wrong position, and nonunion means it did not heal at all. Confusing the two is the most common error in fracture follow-up coding. The ICD-10-CM Official Guidelines for Coding and Reporting, co-maintained by CMS and NCHS, give each outcome a specific clinical definition.

That definition has to appear in the medical record before you assign the matching character. Documenting the outcome and coding it are the same job, which is why fracture follow-up features so often in medical billing compliance reviews.

Those four characters apply when the original fracture was closed. If the fracture was open, the same outcomes take different letters. Malunion becomes Q or R depending on the open fracture type, as S82.026R shows.

Nonunion becomes M or N on the same basis. Check the initial encounter note for the open or closed determination before you pick from either set.

The critical point is what each character demands from the record. Malunion requires evidence that healing has occurred, with bone consolidation visible on imaging, but in a faulty position.

Nonunion requires evidence that healing has not occurred. Assigning P when the fracture has not yet healed is incorrect, and assigning K when the bone has healed poorly is equally wrong.

S72.414P code hierarchy and classification

Knowing where S72.414P sits in the ICD-10-CM structure tells you when a lookup has reached full specificity. The parent-to-child path below is what a coder walks down from the chapter to the billable code.

Related sibling codes for closed fracture with malunion

S72.414P belongs to a family of sibling codes that vary by displacement status, laterality, and named condyle. Knowing the full set prevents miscoding when the clinical details differ from this scenario. The AAPC Codify ICD-10-CM lookup gives you a searchable view of the whole S72.4 subcategory.

Practices running sports medicine software with a built-in diagnostic code library have these siblings on hand at the point of documentation. That removes the second lookup a coder would otherwise make later.

When documentation identifies the condyle as lateral or medial, use the named condyle codes rather than the unspecified ones. S72.414P is for cases where the medical record does not say which condyle is involved. Supracondylar fractures sit in their own sub-subcategory, which is where a code such as S72.442C belongs.

The parallel codes ending in M are not the malunion versions of these siblings. S72.414M, for example, means the same fracture on a subsequent encounter for an open type I or II fracture with nonunion. Pairing an M code with a closed fracture note is a mismatch a payer can spot from the claim alone.

Documentation requirements for S72.414P

S72.414P cannot be assigned from a diagnosis label alone. The clinical record has to support every element of the code description on its own terms. Thin documentation is the most common reason for payer audits and retrospective corrections on fracture codes.

Practices using practice management software with integrated clinical documentation can build these requirements straight into the encounter template. The clinician then answers each question while the patient is still in the room.

• Fracture confirmation: A documented diagnosis of condyle fracture of the lower end of the right femur. This may be an orthopedic surgeon’s note, an emergency department record, or an outpatient note from the initial encounter.
• Nondisplacement status: A radiology report or operative note stating that the fracture fragments were non-displaced or in anatomical alignment at diagnosis. Do not infer nondisplacement from the absence of displacement language.
• Condyle involvement: Clinical or radiological evidence of condyle involvement at the distal femur. If the lateral or medial condyle is identifiable, document it so the more specific code can be used.
• Laterality (right): An explicit reference to the right femur in the clinical note, not only in the billing system. Body part abbreviations on their own are insufficient for payer purposes.
• Encounter type (subsequent): The visit note must show that active treatment has concluded. Wording such as “follow-up for fracture management” or “evaluation of fracture healing” supports the subsequent encounter character.
• Closed fracture: Confirmation that the skin overlying the fracture was intact, with no open wound. This is usually stated in the initial encounter note and carried forward. It is what makes P correct rather than Q or R.
• Malunion evidence: Imaging, typically X-ray or CT, showing that the fracture has healed in a position of mal-alignment, angulation, or rotational deformity. A note describing malunion symptoms is insufficient without radiographic support.

Common coding errors to avoid

Fracture code denials in the S72 category cluster around a small set of avoidable errors. Most trace back to 7th character selection, laterality documentation, or a misclassified healing outcome. The denial codes on the remittance usually point straight at which one it was.

Client record management tools that preserve encounter history make this easier to avoid. A coder can confirm that the 7th character on each claim matches the visit type before it goes out.

• Reading M as malunion: This is the trap that sends the most claims back in this subcategory. S72.414M covers an open type I or II fracture with nonunion. For a closed fracture with malunion the code is S72.414P.
• Using character A on a follow-up visit: S72.414A applies only while active treatment is being provided for the first time. Once the patient moves into healing or complication management, D, G, K, or P applies. Character A on a second or third visit triggers immediate edits.
• Confusing malunion (P) with nonunion (K): These are clinically distinct outcomes. Malunion means healed in the wrong position, and nonunion means failed to heal. Swapping them produces an inaccurate record and a claim that is upcoded or downcoded depending on payer policy.
• Wrong laterality: Billing S72.414P for a right femur when the injury was to the left femur, which takes S72.415P. Laterality errors are a frequent source of retrospective adjustments. Confirm the affected side in every follow-up note, not only in the initial encounter record.
• Using an unspecified condyle code when specificity is documented: The record may identify the lateral or medial condyle. If so, the S72.42x or S72.43x codes are more accurate. Check the record before defaulting to unspecified.
• Missing malunion imaging: The P character requires radiographic evidence of malunion. A provider note stating “malunion suspected” is insufficient for payer purposes without imaging. Query the provider or hold the claim until imaging confirms the diagnosis.
• Submitting without fracture origin documentation: S72.414P is a subsequent encounter code, and the payer may require linkage to an initial encounter claim. Make sure the chart holds a prior claim with an initial encounter character for the same fracture. Corrections are still bound by the payer’s timely filing limits.

Where distal femur fractures sit in the S72 category

S72.414P sits within the broader S72 category, which covers every fracture of the femur. Knowing where distal condyle fractures fall against the other femur types routes a coder to the right subcategory faster.

The ResDAC ICD codes in Medicare files resource explains how S72 codes surface in Medicare claims data.

That matters for practices treating older adults with hip and femur injuries. Rehabilitation providers should look at the physical therapy EMR features that carry documentation for these orthopedic cases across a course of visits.

Within S72.4x, separate sub-subcategories cover unspecified condyle fractures (S72.41x), lateral condyle fractures (S72.42x), and medial condyle fractures (S72.43x).

Further sub-subcategories cover the lower epiphysis and the supracondylar region. Verify that the imaging report names the exact fracture location within the distal femur before you select one.

How Pabau keeps 7th character selection accurate across encounters

Most orthopedic and physical therapy practices rebuild encounter history by hand at coding time. A coder opens the previous visit note, works out whether active treatment ended, then hunts through imaging reports for the line that confirms malunion. Each of those steps is a chance to land on the wrong letter.

Practice management software like Pabau keeps that history in one client record. Prior encounters, imaging reports, and previously submitted codes sit together, so a coder can see which visit was the initial encounter without leaving the chart.

Structured note templates prompt for laterality, displacement status, open or closed status, and healing outcome while the clinician is still with the patient.

When the code is confirmed, the claim goes out through the Claim.MD integration, the clearinghouse Pabau submits electronic claims with. The character a coder verified in the chart is the one the payer receives.

The outcome is fewer 7th character corrections after submission. Coders confirm each element from the record instead of from memory, so a claim carrying S72.414P matches the visit it describes.

Streamline fracture code workflows across encounter types

Pabau’s claims management tools help orthopedic and physical therapy practices track patient encounter history, flag subsequent visits, and submit accurate ICD-10-CM codes without manual lookups. See how it works for your practice.

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Conclusion

The 7th character is the most auditable part of this code, so it deserves the last look before the claim leaves. Reaching for M because it resembles malunion produces a claim that contradicts the chart. So does K when the bone has healed poorly.

Orthopedic, physical therapy, and sports medicine practices see distal femur follow-up care often enough for the character choice to feel routine. Routine is where the error hides. Capturing displacement, laterality, encounter type, and healing outcome at the visit removes the guesswork later.

Pabau’s claims management software supports structured documentation and ICD-10-CM code tracking across encounter types. Book a demo to see how it fits the way your practice codes fracture follow-ups.

Continue your research

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