ICD code S79.001G – Unspecified physeal fracture of upper end of right femur

Key takeaways

S79.001G is the billable FY2026 code for an unspecified physeal fracture of the upper end of the right femur, subsequent encounter with delayed healing.

Seventh character G means delayed healing. The nonunion code for the same injury is S79.001K, and malunion is S79.001P.

G applies when the physician documents that the fracture is uniting more slowly than expected but has not declared a nonunion.

Coders frequently misassign the initial encounter character A on follow-up visits, a documentation error that triggers claim rejections and audit flags.

Practice management software like Pabau validates ICD-10 codes against the current code set and submits claims through the Claim.MD clearinghouse.

ICD-10 code S79.001G: Quick reference

Before reviewing documentation requirements or sibling codes, confirm the core attributes of S79.001G. Each field below has billing implications.

Practices managing orthopedic billing at scale can verify code validity through the CDC/NCHS ICD-10-CM web tool before each submission. Routing the code through medical claims management software adds a check against the current code set. That catches a retired or wrongly sequenced code before it reaches the payer.

Full description: Unspecified physeal fracture of upper end of right femur

Each word in the long description carries clinical and billing weight. Misread one and the code shifts to a different encounter type or anatomical site.

• Unspecified physeal fracture: The fracture involves the physis (growth plate) but the record does not identify the injury pattern. At the upper end of the femur, ICD-10-CM offers only three type options: unspecified (S79.00-), Salter-Harris Type I (S79.01-), and other (S79.09-). When the operative or imaging report does not document the pattern, “unspecified” is the correct selection.
• Upper end of femur: This refers to the proximal femur, the region of the femoral head, neck, and greater and lesser trochanters. The growth plate at this location is distinct from lower end physeal injuries, which carry their own S79.1- codes.
• Right femur: Laterality is embedded in the code itself. S79.001G is right-side specific. Using this code for a left-sided injury, or when documentation does not specify laterality, is a coding error that payers can flag on audit.
• Subsequent encounter: This is not the first contact for this fracture. The patient has received active treatment and is returning for ongoing management, evaluation, or follow-up care.
• Fracture with delayed healing: Union is taking longer than the physician expected for this injury, but the fracture has not been declared a nonunion. That distinction is what separates G from K, and it has to come from the physician’s own words in the record.

Understanding the seventh character G in ICD-10 fracture codes

The seventh character is the most frequently miscoded element in the S79.001 family, and G is the one coders most often get wrong. G means delayed healing, and nonunion is character K instead. The table below shows all six applicable characters for this base code, plus when to select each one.

The practical distinction between D, G, and K is physician documentation, not time elapsed. A follow-up visit six months post-injury may still warrant D if the physician documents normal healing progression. The shift to G requires wording such as “delayed union” or “slow to heal,” and the shift to K requires an explicit nonunion determination. Coding G when the record documents nonunion, or K when it only notes slow progress, means the claim no longer matches the medical record.

The map below runs the same logic in the direction a coder works, from the phrase in the note to the character it supports.

Code hierarchy and classification

S79.001G sits within a defined hierarchical path. Reading that path helps coders cross-check a selection against the tabular list structure before the code goes on a claim.

• S00-T88: Injury, poisoning, and certain other consequences of external causes
• S70-S79: Injuries to the hip and thigh
• S79: Other and unspecified injuries of hip and thigh
• S79.0: Physeal fracture of upper end of femur
• S79.00: Unspecified physeal fracture of upper end of femur
• S79.001: Unspecified physeal fracture of upper end of right femur
• S79.001G: Subsequent encounter for fracture with delayed healing

Each level of the hierarchy narrows the clinical picture. The path runs from general injury to hip region, then physeal injury, upper end, unspecified type, right side, and finally healing status. Coders using the AAPC Codify ICD-10-CM lookup can navigate this path directly to confirm the full tabular list description before submitting.

Sibling and related codes for S79.001G

Three axes differentiate the codes around S79.001G: healing status in the seventh character, laterality in the sixth, and fracture type in the fourth and fifth. The table below covers the adjacent codes coders reach for most often.

One structural point trips coders up here. The upper end of the femur has no Salter-Harris Type II, III, or IV codes. Those exist only at the lower end, under S79.12-, S79.13-, and S79.14-. A typed injury at that site takes a code such as S79.141A. At the proximal physis your only typed options are Salter-Harris Type I (S79.011G) and “other” (S79.091G). S79.001G covers the encounters where the record leaves the type unspecified.

Clinical context: Physeal fractures of the proximal femur

Physeal fractures at the proximal femur occur at the growth plate, the cartilaginous zone between the epiphysis and metaphysis where longitudinal bone growth originates. This structure is present in skeletally immature patients and closes progressively through adolescence.

In growing patients, the physis is mechanically weaker than the surrounding ligamentous structures. High-energy trauma can therefore produce growth plate disruption rather than ligament tears, a pattern that rarely presents in adults whose physes have fused.

Proximal femur physeal injuries can affect multiple anatomical zones: the capital femoral epiphysis, the greater trochanteric apophysis, and the lesser trochanteric apophysis. Slipped capital femoral epiphysis (SCFE) is a distinct but related condition coded separately under the M93 family rather than S79.

The proximal femur also has a precarious blood supply, which is part of why healing here can stall. That vascular risk matters for coding. A delayed healing encounter at this site tends to generate more imaging and closer follow-up than the same character would elsewhere. Expect the record to carry repeat radiographs, and expect the payer to read them.

Delayed healing vs nonunion: What separates G from K

This is the distinction the whole code turns on, and it is where most S79.001G errors start. Delayed healing means the fracture is still uniting, just behind schedule. Nonunion means the physician has concluded that the fracture will not unite without intervention. The first is a timing judgment; the second is a prognosis.

The ICD-10-CM Official Guidelines set no fixed timeframe for either determination. Both rest on physician judgment supported by clinical and radiographic findings, which makes the medical record the decisive factor in code selection. Four healing outcomes map to distinct seventh characters:

• Routine healing (character D): The fracture is progressing toward consolidation as expected. Follow-up visits continue standard monitoring and rehabilitation management.
• Delayed healing (character G): Union is taking longer than the physician anticipated, but it is still expected. Documentation typically reads “delayed union,” “slow to heal,” or “limited callus for time since injury.” This is the character in S79.001G.
• Nonunion (character K): The physician has determined the fracture will not heal without intervention. This calls for S79.001K, and it typically corresponds to additional workup, revision surgical planning, or bone grafting discussions.
• Malunion (character P): The fracture has healed, but in an incorrect anatomical position. This is a separate complication from both delayed healing and nonunion, and it requires character P.

The shift from D to G is a billing event as much as a clinical one. It can trigger a different coverage review, different authorizations, and different decision trees in the payer’s adjudication logic. Read the assessment first, then pick the character it supports.

Coding guidelines and documentation requirements

Supporting S79.001G at audit requires specific documentation elements. Missing any one of them creates a claim that can be denied or downcoded during medical record review.

• Physician statement of delayed healing: The attending or treating physician must document that union is behind schedule. Radiographic findings alone, without physician interpretation, do not satisfy this requirement. A note that stops at “no callus formation” with no clinical assessment attached may be read as insufficient on review.
• No nonunion declaration in the note: If the physician has actually declared the fracture a nonunion, the correct code is S79.001K, not S79.001G. Read the assessment before you assign the seventh character.
• Laterality confirmed in documentation: The right side must be clearly identified in the operative, progress, or imaging note tied to the encounter. Do not infer laterality from prior visits or assume it from the patient’s history.
• Subsequent encounter context: The note must reflect that this is a follow-up contact for an injury that was previously treated. If the patient presents for the first time with a fracture that was managed elsewhere, character A may still apply. It would cover the receiving provider’s initial evaluation. Check payer policy and the documentation context.
• Fracture type documentation: If the operative or imaging report specifies a pattern, use the typed code (S79.011G or S79.091G). It is more specific than S79.001G.

Common coding errors to avoid with S79.001G

Five errors account for most denials on this code. Each one is visible in the note before the claim goes out.

• Treating G as the nonunion character: This is the most common error in the family. G means delayed healing, and nonunion is K, but the two letters sit next to each other in the sequence.
• Applying character A to a clear follow-up visit: Once the patient has had active treatment, any return for the same fracture is subsequent.
• Defaulting to S79.009G when the side is documented: Unspecified laterality is a last resort, not a shortcut, and payers flag it.
• Reaching for Salter-Harris Type II, III, or IV codes at the upper end: They do not exist at this site. Codes like S79.021G and S79.041G are not valid ICD-10-CM codes and will reject on submission.
• Coding G on a note that only says “healing well”: Routine progress is D. G needs the physician to say that healing is behind schedule.

Each of these errors leaves a trail that payers pick up on routine review. Checking the rejection against a reference of denial codes shows which single-character mistake triggered the edit. On a code this specific, one wrong letter is enough.

Related CPT codes for proximal femur physeal fracture treatment

The table below identifies the procedural codes most commonly reported alongside S79.001G in orthopedic and pediatric surgical encounters. Any CPT-ICD pairing should be validated by a certified coder against current AMA CPT descriptors and payer LCD policies before submission.

CPT codes 27516, 27517, and 27519 all carry distal femur descriptors in their official AMA language. Confirm with a certified orthopedic coder whether they apply to the proximal site in your clinical scenario. Stalled-healing cases usually need pre-authorization for the surgical CPT code paired with S79.001G. Payer medical necessity criteria vary by plan, so settle them before the case is scheduled.

Approximate synonyms and index references for S79.001G

Coders locate S79.001G through the ICD-10-CM alphabetical index using several entry paths. Knowing the synonyms helps when the clinical documentation uses terminology that differs from the tabular list description.

• Growth plate fracture, right proximal femur: Lay clinical term for the same concept as physeal fracture. Use the index entry “Fracture, traumatic, femur, upper end, physeal” to reach S79.00-
• Epiphyseal fracture, right femur, proximal: Anatomical synonym for physeal fracture at the growth plate
• Capital femoral epiphysis fracture: When the injury involves the femoral head epiphysis rather than a broader physeal zone. Confirm the tabular list entry before coding
• Physeal injury, right femur, upper end: Clinical documentation variant; maps to S79.001 base with the seventh character determined by encounter context
• Delayed union, right proximal femur physeal fracture: Documentation phrase that supports character G when the treating physician uses it. A documented nonunion sends you to S79.001K instead

The ICD10Data listing for the S79.0 category shows every valid code in the family side by side. That is the fastest way to confirm a seventh character before submission. Practices handling a high volume of pediatric orthopedic encounters can also cross-reference synonyms against the ResDAC ICD codes guidance. It explains how these codes appear in Medicare claims data and research datasets.

How Pabau supports accurate coding on S79.001G claims

In most orthopedic practices, a coder chooses the seventh character while reading a progress note days after the visit. It is then typed by hand into a claim form. No step in that chain checks the letter against what the physician actually wrote. The delayed healing and nonunion codes differ by one character, so the error survives all the way to the payer.

Practice management software like Pabau removes that hand-off. Codes are stored against the encounter rather than re-keyed per claim. The value the clinician selected in the note is the one that reaches the payer. Built-in ICD-10 validation checks each code against the current code set before submission. That catches invalid combinations, such as a Salter-Harris Type II code at the upper end of the femur.

Pabau also connects to the Claim.MD clearinghouse for real-time eligibility verification and clean electronic submission. Code validation sits inside the billing workflow rather than at the end of it. For orthopedic and sports medicine teams, that turns a manual review step into a check running on every claim.

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Conclusion

S79.001G is a narrow code with one job. It reports a follow-up encounter for a right proximal femur growth plate fracture that is healing more slowly than expected. Delayed healing is what the G stands for. If the physician has declared the fracture a nonunion, the code is S79.001K, and if it has united in a bad position, it is S79.001P.

Laterality, the physeal location, the encounter status, and the healing status all have to appear in the medical record. Otherwise the code will not survive audit. Getting the seventh character wrong on a follow-up claim is the single most common error in this code family. It is also entirely preventable with clear documentation protocols.

Is your practice managing complex fracture follow-up billing? Book a demo to see how Pabau builds code validation into the submission process, rather than bolting it on as a manual check.

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