S79.149ASalter-Harris Type IV physeal fracture of lower end of unspecified femur, initial encounter for closed fracture

S79.149A is the ICD-10-CM diagnosis code for Salter-Harris Type IV physeal fracture of lower end of unspecified femur, initial encounter for closed fracture. It belongs to category S79 (other and unspecified injuries of hip and thigh), block S70-S79 (injuries to the hip and thigh) and chapter 19 (injury, poisoning and certain other consequences of external causes). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

The 7th character "A" means initial encounter for closed fracture: use it while the patient is receiving active treatment for the condition.

As a secondary diagnosis it is a CC (complication or comorbidity), which can move an inpatient stay into the "with CC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 533 (Fractures of Femur with MCC, relative weight 1.4649), DRG 534 (Fractures of Femur without MCC, relative weight 0.8403), DRG 963 (Other Multiple Significant Trauma with MCC, relative weight 2.6363), DRG 964 (Other Multiple Significant Trauma with CC, relative weight 1.4972) and DRG 965 (Other Multiple Significant Trauma without CC/MCC, relative weight 1.0059), in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue) and MDC 24 (Multiple Significant Trauma), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It is an unspecified code for which a more specific option (often laterality) exists, and the Medicare Code Editor flags it for review on inpatient claims.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as 821.22 (closed fracture of epiphysis, lower (separation) of femur).