• Skip to main content
  • Skip to secondary menu
  • Skip to primary sidebar
  • Skip to footer
  • About Us
  • Medical Billing Process
  • Insurance Contacts & Addresses
    • with Alphabet A to E
      • Insurance Companies with Alphabet A
      • Insurance Companies with Alphabet B
      • Insurance Companies with Alphabet C
      • Insurance Companies with Alphabet D
      • Insurance Companies with Alphabet E
    • With Alphabet F to J
      • Insurance Companies with Alphabet F
      • Insurance Companies with Alphabet G
      • Insurance Companies with Alphabet H
      • Insurance Companies with Alphabet I
      • Insurance Companies with Alphabet J
    • With Alphabet K to O
      • Insurance Companies with Alphabet K
      • Insurance Companies with Alphabet L
      • Insurance Companies with Alphabet M
      • Insurance Companies with Alphabet N
      • Insurance Companies with Alphabet O
    • With Alphabet P to T
      • Insurance Companies with Alphabet P
      • Insurance Companies with Alphabet Q and R
      • Insurance Companies with Alphabet S
      • Insurance Companies with Alphabet T
    • With Alphabet U to Z
      • Insurance Companies with Alphabet U
      • Insurance Companies with Alphabet V
      • Insurance Companies with Alphabet W to Z
  • BCBS Prefix
    • BCBS Alpha Prefix
      • Prefix with Alphabet A to E
        • Prefix List (AAA to AZZ)
        • Prefix List (BAA to BZZ)
        • Prefix List (CAA To CZZ)
        • Prefix List (DAA To DZZ)
        • Prefix List (EAA to EZZ)
      • Prefix with Alphabet F to J
        • Prefix List (FAA to FZZ)
        • Prefix List (GAA to GZZ)
        • Prefix List (HAA to HZZ)
        • Prefix List (IAA to IZZ)
        • Prefix List (JAA to JZZ)
      • Prefix with Alphabet K to O
        • Prefix List (KAA to KZZ)
        • Prefix List (LAA to LZZ)
        • Prefix List (MAA to MZZ)
        • Prefix List (NAA to NZZ)
        • Prefix List (OAA to OZZ)
      • Prefix with Alphabet P to T
        • Prefix List (PAA to PZZ)
        • Prefix List (QAA to QZZ)
        • Prefix List (RAA to RZZ)
        • Prefix List (SAA to SZZ)
        • Prefix List (TAA to TZZ)
      • Prefix with Alphabet U to Z
        • Prefix List (UAA to UZZ)
        • Prefix List (VAA to VZZ)
        • Prefix List (WAA to WZZ)
        • Prefix List (XAA to XZZ)
        • Prefix List (YAA to YZZ)
        • Prefix List (ZAA to ZZZ)
    • BCBS Alpha Numeric Prefix
      • Prefix with Alphabet A to E
        • Prefix List (A2A To A9Z)
        • Prefix List (B2A To B9Z)
        • Prefix List (C2A To C9Z)
        • Prefix List (D2A To D9Z)
        • Prefix List (E2A to E9Z)
      • Prefix with Alphabet F to J
        • Prefix List (F2A to F9Z)
        • Prefix List (G2A to G9Z)
        • Prefix List (H2A to H9Z)
        • Prefix List (I2A to I9Z)
        • Prefix List (J2A To J9Z)
      • Prefix with Alphabet K to O
        • Prefix List (K2A To K9Z)
        • Prefix List (L2A To L9Z)
        • Prefix List (M2A To M9Z)
        • Prefix List (N2A To N9Z)
        • Prefix List (O2A To O9Z)
      • Prefix with Alphabet P to T
        • Prefix List (P2A To P9Z)
        • Prefix List (Q2A To Q9Z)
        • Prefix List (R2A To R9Z)
        • Prefix List (S2A To S9Z)
        • Prefix List (T2A To T9Z)
      • Prefix with Alphabet U to Z
        • Prefix List (U2A To U9Z)
        • Prefix List (V2A To V9Z)
        • Prefix List (W2A To W9Z)
        • Prefix List (X2A To X9Z)
        • Prefix List (Y2A To Y9Z)
        • Prefix List (Z2A To Z9Z)
  • CPT Codes
  • Modifiers
Billing Executive

Billing Executive

Medical Billing Knowledge Base

  • Medical Billing
  • Medical Coding
  • CMS
  • Private Payers
  • Billing Errors
  • Resources
  • Buy Books & Courses

Guidelines For ICD-10 7TH Character

July 6, 2022 by Aamir247 Leave a Comment

In ICD-10, there are seven possible characters for filling out a code. The first three offer the diagnosis category. The second set of three corresponds to the diagnostic’ etiology, i.e., the cause and any further clarifying information. Then there’s the seventh Character. The seventh Character is an expansion generally used to mark episodes of care for injuries and other conditions caused by external factors.

Guidelines For ICD-10 7TH Character

The ICD-10 7th Character is only required when the ICD-10 regulations request it and provide you an option between many characters. A 7th character usually is only necessary in the case of injuries for PT/OT.

Common 7th characters

A, D, and S are the most common seventh characters. Because you virtually always give care during the healing or recovery phase of an injury as a therapist, you will employ the D character. More precisely, the following describes when each Character is used.
The following section explains when each Character is used.

Character A: This Character deals with the initial encounter that occurs when the patient is actively receiving therapy for the injury, poisoning, or other external cause-related consequences

For example: If the practitioner sends the patient to the emergency room, all three treating providers would code the injury with “A” Initial Encounter.

Character D: It is related to subsequent encounter, which is used during the healing phase following the active phase to check the patient is recuperating correctly. Most PT/OT, including your initial evaluation, is viewed as a subsequent encounter during a care episode. Utilize character D for the great majority of PT/OT care that requires a 7th character,

Character S: The seventh Character, S, discovers the source of the sequela. (Complications caused by a previous injury) For example: burn scar.

Alternative 7th Characters For Fracture Care
Fracture coding typically requires one of the following 7th characters as an alternative to these A, D, and S 7th characters; however, the ICD-10 tables or tool you are using should expressly ask for one of these characters.

Character A: The seventh Character, S, discovers the source of the initial encounter for closed fracture.
Character B: The seventh Character, S, discovers the source of the initial encounter with an open fracture.
Character D: The seventh Character S discovers the source of subsequent encounter for fracture with routine healing.
Character G: The seventh Character S discovers the source of subsequent encounter for fracture with delayed healing.
Character K: The seventh Character S discovers the source of subsequent encounter for fracture with non-union.
Character P: The seventh Character S discovers the source of subsequent encounter for fracture with mal union.
Character S: The seventh Character, S, discovers the source of sequela.

Proven Strategies for Mastering ICD-10 7th Characters
Following guidelines can help you improve your diagnosis coding abilities.

Don’t Ignore 7th Character Requirements.
If an ICD-10 code requires a seventh character, you must report a seven-character code. Payers will not accept incomplete codes. That is an apparent suggestion, but as Tips 2 and 3 prove that getting the 7th Character on your code isn’t always easy.

Understand When to Use Placeholder X

In several codes, ICD-10-CM employs the placeholder character X. This occurs when a code demands a later character in a particular position. Yet, the code lacks specific characters for one or more places before that Character. The ICD-10-CM code system allows for future expansion by utilizing a placeholder.

Search Consistently Your 7th Character
Many ICD-10-CM resources include the 7th character requirement and the alternatives for those characters at the category (three-character) level. There may be no indication at any subcategory levels that a 7th character is required.
Choose an ICD-10-CM resource that tells you of additional code needs at each level, if possible, so you don’t have to look for them. Easy access to 7th character standards reduces the risk of claim issues due to incomplete codes.

Get to Know Your Potential Options

The following three choices opt as the 7th Character
1. Character A (first encounter)
2. Character D (second encounter)
3. Character S (sequela)

Consult the Official Guidelines, For 7th Character Explanations

The explanations of the phrases used for the seventh characters are not obvious; however, reading the appropriate sections in the ICD-10-CM Official Guidelines can help you understand the purpose of these characters.
Add to Your Fracture Options
Traumatic fracture categories contain additional 7th character values, so don’t just stick to A, D, or S on the end of a fracture code and think you’re done.

About us

Billing Executive – a Medical Billing and Coding Knowledge Base for Physicians, Office staff, Medical Billers and Coders, including resources pertaining to HCPCS Codes, CPT Codes, ICD-10 billing codes, Modifiers, POS Codes, Revenue Codes, Billing Errors, Denials and Rejections.

We have more than 10 years experience in US Medical Billing and hand-on experience in Web Management, SEO, Content Marketing & Business Development with Research as a special forte.

Learn More:

A Comprehensive Guideline To ICD-10 Codes

A Comprehensive Guideline To Modifier 25

Denial CO 11: Diagnosis is inconsistent with The Procedure

CO12 Denial Code: Diagnosis is inconsistent with the Provider Type

Post Views: 9

Filed Under: Medical Billing, Medical Coding, Posts, Resources Tagged With: 7th character, ICD-10, ICD10, medical billing, medical Coding

Reader Interactions

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Primary Sidebar

Medical Billing & Coding Books

1 Stop Medical Billing Solutions

Save Time & Money by choosing “ONE STOP“ Solutions!

Revenue Cycle Management
Online Reputation
Virtual Staffing (RPO)

Free Standing Emergency Rooms, Micro Hospitals

www.rcmxpertz.com

Books for HCPCS & CPT Codes 2023

E-mail Newsletter

  • Facebook
  • GitHub
  • Instagram
  • Pinterest
  • Twitter
  • YouTube

Medical Jobs & Projects

  • Integrated Medical Services (IMS)

    Certified Medical Coder

    • Phoenix, AZ
    • Integrated Medical Services (IMS)
    • Full Time
  • Yeo & Yeo

    Medical Biller

    • Saginaw, Michigan
    • Yeo & Yeo
    • Full Time
  • UnitedHealth Group

    (OP) Medical Coder

    • HARTFORD, CONNECTICUT
    • UnitedHealth Group
    • Full Time
  • Aston Carter

    Medical Biller

    • Atlanta - Fulton County - GA Georgia - USA
    • Aston Carter
    • Full Time
  • Yeo & Yeo Affiliated Medical Billing

    Medical Biller

    • Saginaw, Michigan
    • Yeo & Yeo Affiliated Medical Billing
    • Full Time

Footer

Billing Executive – a “Medical Billing and Coding Knowledge Base” for Physicians, Office staff, Medical Billers and Coders, including resources pertaining to HCPCS Codes, CPT Codes, ICD-10 billing codes, Modifiers, POS Codes, Revenue Codes, Billing Errors, Denials and Rejections. Learn more about us!

Quick Links

  • Expert Advice for Medical Billing & Coding
  • Medical Billing and Coding Courses
  • List a Medical Billing Job or a Project
  • Medical Billing and Coding Jobs
  • Contact Us

Subscribe via Email

  • Privacy Policy

Proudly created by AJ Graphics

DISCLAIMER: Billing Executive does not claim ownership of all the informational content published or shared on this website, including any content shared by third parties. The content published or shared on this website, including any content shared by third parties is for informational/educational purposes.