The chapters in which the 7th character is utilized are:
? Obstetrics
? Injury
? Musculoskeletal and
? External Cause
It is not used in every chapter and if used may have a different meaning depending on the section where it is being used. It must be used in the 7th character position using the x place holder if necessary. It should be noted that when a 7th character applies and it is not used the code is considered invalid.
Below is an example of how the 7th character is used chapter wise:
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