Each month, IBC will feature an example of how ICD-9 codes will translate to
ICD-10 codes. We will present coding examples from different specialties and
popular disease categories to demonstrate the granularity that the new ICD-10
code set will provide.
Coding convention: Seventh character extension
One example of how ICD-10 codes differ from ICD-9 codes is the addition of a
seventh character extension in the coding structure. The seventh character
extension in ICD-10 codes is primarily used to document the episode of care for
fractures, injuries, poisonings, other consequences of external causes, and
conditions that affect a fetus at multiple gestations. The designation of the
seventh character extension in ICD-10 conveys greater specificity and clinical
detail.
For injuries, poisonings, and other consequences of external causes, the
seventh character designates the episode of care as:
A = Initial Encounter
D = Subsequent Encounter
S = Sequela
Condition
Clinical documentation
ICD-10 code
Injury
Superficial foreign body of unspecified shoulder, initial encounter
S40.259A
Poisoning
Poisoning by penicillins, accidental (unintentional), subsequent encounter
T36.0x1D*
Consequences of external causes
Adverse effect of benzodiazepines, sequela
T42.4x5S*
Note: Fractures are not included in these examples
due to the complexity of assigning seventh characters for episode of care.
For conditions that affect a fetus, the seventh character designates certain
complications of pregnancy at multiple gestations to denote which fetus is
affected:
0 = not applicable or unspecified
1 = fetus 1
2 = fetus 2
3 = fetus 3
4 = fetus 4
5 = fetus 5
9 = other fetus
Condition
Clinical documentation
ICD-10 code
Maternal care for breech presentation, fetus 1
O32.1xx1*
Maternal care for (suspected) central nervous system malformation in fetus,
fetus 2
O35.0xx2*
Maternal care for anti-D [Rh] antibodies, second trimester, fetus 3
O36.0123
Polyhydramnios, third trimester, fetus 4
O40.3xx4*
Infection of amniotic sac and membranes, unspecified, second trimester, fetus 5
O41.1025
Complication of pregnancy affecting fetus
Labor and delivery complicated by cord around neck, with compression, other
fetus
O69.1xx9*
*For codes that include only three to five
characters, ?x? is used to fill in empty character fields.
For additional information related to IBC?s transition to ICD-10, please refer
to the
ICD-10 section of
our website.