What is the maximum length of an ICD-10-CM code?

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The maximum length of an ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) code is 7 characters.

Structure of ICD-10-CM Codes:

ICD-10-CM codes can be 3 to 7 characters long, depending on the specificity required for a diagnosis. Each character provides additional detail:

1. First Character: A letter indicating the chapter or category (e.g., "M" for musculoskeletal conditions).

2. Second & Third Characters: Usually numbers, completing the category code (e.g., M16 = osteoarthritis of hip).

3. Fourth to Sixth Characters: Can be letters or numbers, providing clinical details, such as:

   • Cause

   • Anatomical site

   • Severity

4. Seventh Character: Used in certain codes (mostly for injuries or pregnancy-related conditions) to show the episode of care:

   • A = Initial encounter

   • D = Subsequent encounter

   • S = Sequela (complication or condition that arises from a previous condition)

Example of a 7-Character Code:

• S52.521A

  • S = Injury

  • 52 = Fracture of the forearm

  • .521 = Torus fracture of lower end of right radius

  • A = Initial encounter

Key Points:

• Not all codes require 7 characters.

• When a 7th character is needed, and the code is shorter than 6 characters, placeholder "X" is used to ensure correct placement.

Example with Placeholder:

• T81.4XXA

  • Here, two "X"s are used as placeholders before the 7th character.

In summary, 7 characters is the maximum length, allowing detailed, specific medical coding for accurate diagnosis and billing.

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