What does the seventh character in ICD-10-CM signify?

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In ICD-10-CM, the seventh character is used in certain code categories to provide additional information about the episode of care or the nature of the condition, especially in injury, obstetric, and fracture-related codes. It is required in these codes and must appear in the seventh position, even if placeholders (usually "X") are needed to fill empty positions.

What the Seventh Character Signifies:

In injury and fracture coding, it typically indicates the encounter type:

• A – Initial encounter (active treatment phase)

• D – Subsequent encounter (healing or recovery phase)

• S – Sequela (complications or conditions arising as a direct result of a previous injury)

Example:

A patient with a displaced fracture of the right radius:

• Code: S52.521A

  • S52.521 – Displaced fracture of shaft of right radius

  • A – Initial encounter

Important Notes:

• The seventh character is not optional when required—it must be included for the code to be valid.

• If the base code has fewer than six characters, you must use "X" as a placeholder to ensure the seventh character is in the correct position.

Example with placeholder:
T15.90XA – Foreign body in unspecified eye, initial encounter
("X" is the placeholder to make room for "A" as the 7th character)

Summary:

The seventh character in ICD-10-CM provides important context about the stage or type of care, ensuring accurate and specific coding for injuries, complications, and certain conditions.

Read More

What is a placeholder in ICD-10-CM coding?

Explain the structure of an ICD-10-CM code.

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