ICD-10 code S72.446E: Nondisplaced fracture of medial condyle of left femur

Key Takeaways

ICD-10 code S72.446E describes a nondisplaced fracture of the medial condyle of the left femur – subsequent encounter for an open fracture type I or II with routine healing.

S72.446E is a billable ICD-10-CM code, valid for fiscal year 2026 (effective October 1, 2025).

The 7th character E is the critical selector here: it signals a subsequent encounter for an open fracture type I or II where healing is progressing normally – not a sequela or initial visit.

Pabau’s claims management software integrates with Claim.MD to validate ICD-10 diagnostic codes before submission, reducing denials caused by incorrect encounter characters or laterality errors.

ICD-10 code S72.446E is a billable ICD-10-CM diagnosis code. It became effective on October 1, 2025, and is valid for fiscal year 2026. The full official description is: Nondisplaced fracture of medial condyle of left femur, subsequent encounter for open fracture type I or II with routine healing.

According to the CDC/NCHS ICD-10-CM web tool, S72.446E sits within the S72 category, which covers all fractures of the femur. The code is billable and specific, meaning it can be submitted directly on a claim without requiring additional hierarchy codes.

S72.446E code details at a glance

The table below summarises the key metadata for ICD-10 code S72.446E as published in the 2026 ICD-10-CM tabular list.

Code hierarchy: Where S72.446E sits in ICD-10-CM

ICD-10 code S72.446E belongs to a well-defined hierarchy in the CMS ICD-10-CM code set. Understanding the parent-to-child path helps coders navigate adjacent codes and select the correct specificity level.

The S72.4 subcategory specifically covers the lower end (distal) of the femur. This distinguishes distal femur fractures from femoral neck fractures (S72.0), intertrochanteric fractures (S72.1), and subtrochanteric fractures (S72.2). Coders encountering ICD-10 diagnostic code selection for musculoskeletal injuries will find that the hierarchy at S72 is particularly detailed because of the clinical complexity of femur fractures.

Clinical definition: Nondisplaced fracture of the medial condyle of the left femur

The medial condyle is the rounded protrusion on the inner (medial) side of the distal femur. It articulates with the medial tibial plateau to form part of the knee joint. Fractures at this site typically result from high-energy trauma, such as a fall from height, a motor vehicle collision, or a direct blow to the lateral knee that drives the femoral condyle inward.

A nondisplaced fracture means the bone has cracked or broken but the fracture fragments have not shifted from their anatomical position. This distinction matters enormously for coding because ICD-10-CM treats displaced and nondisplaced fractures as separate codes throughout the S72 family.

• Nondisplaced: Fracture line present; bone fragments remain in anatomical alignment. Maps to S72.446 (with appropriate 7th character).
• Displaced: Fracture fragments have moved out of anatomical alignment. Maps to S72.445 (with appropriate 7th character).
• Laterality: Left femur = S72.446x; Right femur = S72.445x for displaced or S72.446 right-side equivalent; bilateral = S72.447x.

Coders working in orthopedic or sports medicine software environments should confirm laterality directly from the operative note or imaging report. Selecting the right-side code for a left-side fracture is one of the most common claim denial triggers in this code family.

Understanding the 7th character “E”: Subsequent encounter

The 7th character in ICD-10 code S72.446E is the most consequential element for billing. The letter E designates a subsequent encounter for an open fracture type I or II with routine healing. Under the ICD-10-CM Official Guidelines, subsequent encounters are used for all visits after the initial treatment when the patient continues to receive active care for the condition.

Three concepts combine to produce the E qualifier. First, this is a subsequent encounter, not an initial or sequela visit. Second, the underlying fracture was classified as an open fracture type I or II. Third, the healing is progressing normally, meaning no delayed union, nonunion, or malunion has been documented. If any of those three elements changes, a different 7th character applies.

Consistent, accurate selection of the correct ICD-10 encounter code across all specialties is enforced by HIPAA, which mandates ICD-10-CM for all covered-entity diagnostic coding. Submitting an initial-encounter code on a follow-up visit, or a subsequent-encounter code on a first visit, is a coding error that payers actively audit.

Open fracture classification: Type I and type II

ICD-10 code S72.446E is specifically tied to open fractures classified as Gustilo type I or type II. The Gustilo-Anderson classification is the standard orthopedic grading system for open fractures, distinguishing them by wound size, contamination level, and associated soft-tissue damage.

The distinction between type I/II and type IIIA/IIIB/IIIC is critical because it drives different 7th character values across the entire S72 code family. A type IIIA fracture that heals routinely uses F, not E. Conflating the two is a well-documented source of claim denials in orthopedic billing.

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Full list of 7th character extensions for S72.446

S72.446 is the code stem for nondisplaced fracture of the medial condyle of the left femur. Every valid 7th character extension produces a separate billable code. The complete table below supports accurate code selection across all encounter types and healing statuses.

Related codes in the S72.446 family

S72.446E belongs to the S72.446 family, which exclusively covers nondisplaced fractures of the medial condyle of the left femur. Coders should be aware of its immediate neighbors for laterality and displacement comparisons. Accurate ICD-10 diagnostic code selection always starts with confirming laterality from the source documentation.

For reference, verify any related code against the ICD List ICD-10-CM lookup, which mirrors official CMS/NCHS data and is updated for each fiscal year.

Common coding errors and documentation requirements

Errors on S72.446E claims fall into four predictable patterns. Addressing each at documentation capture prevents the rework. Denial management workflows in orthopedic practices frequently trace back to these four failure points.

• Wrong laterality: Coding S72.446E (left femur) when the fracture is right-sided is one of the most common errors. Confirm laterality from the radiograph report, operative note, or discharge summary before coding. Never default to “unspecified.”
• Initial vs subsequent encounter mismatch: Using S72.446E on a first-visit encounter, or using the initial-encounter code S72.446B on a follow-up visit, triggers an edit. The encounter character must reflect the actual visit type documented in the record.
• Open fracture type confusion: Selecting the E qualifier (type I or II) when the operative note documents type IIIA is a substantive coding error. Types IIIA, IIIB, and IIIC use the F qualifier for subsequent encounters with routine healing.
• Healing status not documented: The E qualifier requires routine healing. If the provider documents concerns about delayed union, nonunion, or malunion, the 7th character must change to H, M, or Q respectively. Coders cannot assume routine healing without documentation.

From a medical billing compliance standpoint, each of these errors is auditable. CMS and commercial payers apply coding edit software that flags fracture codes where the encounter character conflicts with the patient’s episode timeline on record.

How Pabau supports accurate ICD-10 diagnostic coding

Orthopedic and physical therapy EMR workflows involve dozens of fracture follow-up visits per provider each week. Each one requires a correctly assigned 7th character, confirmed laterality, and documented healing status. Pabau’s clinical documentation features capture encounter context at the point of care, reducing the gap between what the provider documents and what the coder applies.

Pabau integrates with Claim.MD, a US medical claims clearinghouse supporting over 4,000 payers. When a claim containing ICD-10 code S72.446E is submitted through electronic claims via Claim.MD, the clearinghouse runs real-time eligibility checks and validates code sets before transmission to the payer. Claim rejections caused by incorrect encounter characters or mismatched open fracture type qualifiers are caught at this stage, before the claim reaches the payer’s adjudication queue.

For practices managing high volumes of fracture follow-ups, Pabau’s claims management software tracks denial reasons per code, enabling coders to identify patterns like repeated E-vs-F confusion or laterality mismatches across a provider’s claim history.

That pattern data directly informs coding education. Practices seeking to reduce rework can also review HIPAA-compliant clinic software requirements to ensure their documentation workflows meet payer audit standards.

Conclusion

ICD-10 code S72.446E is a narrow but precise code. Three variables lock it in place: nondisplaced fracture, medial condyle of the left femur, and a subsequent encounter where an open fracture type I or II is healing routinely. Change any of those variables and you need a different code. The tables in this reference give you the full 7th character set, the adjacent code family, and the Gustilo classification crosswalk needed to select correctly across every visit type.

For practices that want clean claims on the first submission, Pabau’s integration with Claim.MD validates ICD-10 diagnostic codes in real time before they reach the payer. See how it works by visiting revenue cycle management with Pabau or book a demo to see the full clinical documentation and billing workflow.

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