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December 3, 2015

Understanding ICD-10’s Seventh Character

December 3, 2015

Outsource Medical Billings

The number seven pops up a lot throughout history. The Bible says it took God seven days to create the Earth (and rest). If you break a mirror, you get seven years’ bad luck. Seven is a lucky number that inevitably shows up on millions of lotto tickets each week.

But for ICD-10 coding, the number seven takes on a special significance, primarily because of the presence of the seventh character in a code.

Here’s more on the seventh character and what it represents, courtesy of a medical billing company that specializes in ICD-10 coding.

What Is the Seventh Character?

In ICD-10, there are seven available characters that you can use to fill out a code. The first three provide the category of the diagnosis. The second set of three correspond to the etiology of the diagnosis, i.e. the cause and any other clarifying information. Then, there’s the seventh character.

This is one of the main ways ICD-10 is different from the old ICD-9 system. The seventh character is an extension, primarily used to document episode of care for injuries and other conditions with external causes. There are several characters that can go here:

  • A: Initial encounter (the active phase of treatment)
  • D: Subsequent encounter (care that is performed after the active phase of treatment, such as rehabilitation)
  • S: Sequela (a complication that arises from an injury)

There are additional letters for various diagnoses. Fractures, for example, have – you guessed it – seven options, including codes for fractures with delayed healing, fractures with routine healing, and fractures with nonunion.

ICD-9 didn’t contain a mechanism by which you could input this information. ICD-10 does. That simple fact alone makes ICD-10 more complicated.

Adapting to ICD-10’s Seventh Character

The presence of the seventh character has caused confusion for many in the field and is a problem for some practices.

Some practices have difficulty determining what, exactly, constitutes active treatment versus a subsequent visit. Others, not used to filling out this information, aren’t exactly sure what to put in that slot.

ICD-10 can be confusing, but fortunately, a lot of that confusion can be eliminated by hiring a medical billing company to handle your billing for your practice. A practice can benefit not only by avoiding complication, but by also reducing costs and increasing efficiency, which always benefits a practice.

Contact Medical Business Management for more information on outsourcing your ICD-10 coding to our medical billing company.

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