7th character

The 7th character to know

Some ICD-10 codes (mainly the injury ones)  have a seventh character at the very end that is required. The majority of this seventh character situations will address a question about WHEN is the encounter occurring, in regards to the injury: 

Remember A - D - S

• A, Initial encounter
• D, Subsequent encounter
• S, Sequela

Initial encounter  =  When the patient is receiving active treatment for the injury (e.g., surgical treatment, emergency department encounter). 


Subsequent encounter = When the patient has received active treatment of the injury and is receiving routine care for the injury during the healing or recovery phase 


Sequela = complications or conditions that arise as a direct result of an injury, such as scar formation after a burn. 

Example: Strain of unspecified muscle and tendon at ankle and foot level, right foot, initial encounter S96.911A

One of the biggest misconceptions about this 7th character ICD-10 is the confusion that subsequent encounter means that ‘it happened twice’.That's obviously incorrect.

So remember ISS (International Space Station):

Initial  - Subsequent -  Sequela