AMA CPT® Assistant - 2014 Issue 12 (December)
ICD-10-CM Seventh (7th) Character (December 2014)
December 2014 pages 13-15 ICD-10-CM Seventh (7th) Character The April and May issues of the CPT Assistant provided information comparing the ICD-9 –CM diagnosis code (hereafter called ICD-9-CM) and ICD-10-CM code structure and format. This article will discuss another important difference between ICD-9-CM and ICD-10-CM: Assignment of a 7th character (also known as 7th character extension) to codes in certain ICD-10-CM categories. In addition, this article will focus on the ICD-10-CM structure difference, as it relates to the 7th character, primarily used to document episode of care for injuries, pregnancy, childbirth and the puerperium, and other conditions with external...
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Article Overview
This article reviews ICD-10-CM seventh character usage and how it differs from ICD-9-CM in selected diagnosis categories. It is geared toward coders and billing professionals who need a broad understanding of episode-of-care reporting, fracture coding considerations, and fetus-identification concepts in pregnancy-related coding. The article also references related guideline concepts, chapter groupings, and examples that illustrate the structural use of seventh-character extensions.
Why This Topic Matters
Seventh-character reporting affects diagnosis code completeness and can change how injury, fracture, and pregnancy-related records are represented in ICD-10-CM. Understanding the article helps coding professionals recognize where additional character requirements apply and where related guideline concepts are discussed.
Article Sections
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December 2014 pages 13-15
Introductory discussion of the ICD-10-CM seventh character and how it differs from ICD-9-CM code structure and format. Includes a high-level overview of the major contexts in which seventh-character extensions are used.
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Episode of Care
Overview of seventh-character extensions used to indicate the stage of care for selected conditions. Covers the general categories of encounter timing and related documentation concepts.
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Seventh Character Assignment for Aftercare
Discussion of how aftercare concepts relate to seventh-character coding for certain conditions. Addresses the distinction between general aftercare concepts and categories that use seventh-character extensions.
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Episode of Care for Fractures
Focus on fracture-related seventh-character use and the additional clinical details associated with those codes. Introduces the related concept of open fracture classification.
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Classification for Gustilo Open Fracture
Summary of the Gustilo open fracture classification framework and the broad characteristics used to describe open fractures. Describes the classification structure at a general level without code-specific detail.
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Pathological Vs Traumatic Fractures
Compares broad fracture coding concepts for traumatic and pathological fractures. Includes general discussion of why documentation differences matter in ICD-10-CM.
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Assigning 7th Character for Fetus Identification
Explains the use of seventh-character extensions in selected pregnancy-related categories to identify the fetus affected by a complication. Includes a general overview of multiple gestation reporting concepts and placeholder use.
What You Will Learn
- How ICD-10-CM seventh-character extensions differ from older diagnosis code structure
- Which broad diagnosis categories are associated with seventh-character reporting
- How episode-of-care concepts are described in injury-related coding
- How fracture coding and open-fracture classification are discussed in relation to seventh-character use
- How pregnancy-related coding can require fetus identification through seventh-character extensions
Who Should Read This
- Medical coders
- Coding auditors
- Billing professionals
- Healthcare documentation staff
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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