ICD-10-CM 7th Character and its use

by  Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
May 6th, 2015

The 7th character is used in certain chapters (e.g., Obstetrics, Injury, Musculoskeletal, and External Cause chapters). However,  it is not used in every chapter and may have a different meaning depending on the section where it is being used. One thing that is consistent, is that it must be used in the 7th character position (using the x place holder if necessary). When a 7th character applies and it is not used, the code is considered invalid.

Use of 7th Characters by Chapter

            Multiple gestations – identification of fetus affected by condition

           Type of encounter

           Closed vs. open fracture

           Routine vs. delayed healing

           Malunion or nonunion of fracture

           Type of encounter

           Routine vs. delayed healing

           Malunion or nonunion of fracture

           Additional clinical information

           Type of encounter


7th Character Describing Encounter

 Note: For aftercare of injury, assign acute injury code with 7th character for subsequent encounter.


7th Character – Fractures

     A Initial encounter for closed fracture

     B Initial encounter for open fracture

     D Subsequent encounter for fracture with routine healing

     G Subsequent encounter for fracture with delayed healing

     K Subsequent encounter for fracture with nonunion

     P Subsequent encounter for fracture with malunion

     S Sequela



ICD-10-CM 7th Character and its use. (2015, May 6). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/icd-10-cm-7th-character-and-its-use-31649.html

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