Find-A-Code Focus Newsletter

ICD-10-CM 7th Character And How It Is Used

October 02, 2015

The use of the 7th character 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

  • Obstetric

            Multiple gestations –identification of fetus affected by condition

  •  Injury

           Type of encounter

           Closed vs. open fracture

           Routine vs. delayed healing

           Malunion or nonunion of fracture

  •  Musculoskeletal

           Type of encounter

           Routine vs. delayed healing

           Malunion or nonunion of fracture

           Additional clinical information

  •  External Cause

           Type of encounter

 7th Character Describing Encounter

  •  Initial encounter: As long as patient is receiving active treatment for the condition.

  •  Subsequent encounter: After patient has received active treatment of the condition and is receiving routine care for the condition during the healing or recovery phase.

  •  Sequela: Complications or conditions that arise as a direct result of a condition (e.g., scar formation after a burn).

 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 Sequel



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