How is the ICD-10-CM code structured?

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The ICD-10-CM code structure is designed to provide detailed and specific information about diagnoses. It consists of 3 to 7 alphanumeric characters, each with a defined meaning, allowing for precise classification of medical conditions.

1. Format:

• The first character is always a letter (except the letter U, which is reserved for special use).

• The second and third characters are numbers. Together, the first three characters form the category that broadly identifies a disease or condition.

• Characters four through seven are either letters or numbers and provide increasing levels of specificity such as etiology, anatomical site, severity, or other clinical details.

2. Sections of the code:

• Characters 1-3: Category of the disease or condition. For example, “J45” refers to asthma.

• Character 4: Etiology, anatomical site, or other clinical detail.

• Character 5: Further specification like severity or type.

• Character 6: Additional clinical information.

• Character 7: Often used for extension codes, such as identifying the episode of care (initial, subsequent, sequela) or laterality (left, right, bilateral).

3. Examples:

• A simple 3-character code: “A09” (Infectious gastroenteritis and colitis).

• A more specific 7-character code: “S52.521A” (Displaced fracture of the distal radius, left arm, initial encounter).

This hierarchical, alphanumeric structure enables ICD-10-CM to capture complex medical information efficiently, supporting accurate documentation, billing, and healthcare analytics.

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