Recently, while reviewing terms people use to find CodingIntel I was surprised to find that people were searching for “xxxA.” At first, I was afraid searchers were looking for a different kind of site….or sight.
But searchers were looking for information about placeholder code X and 7th character extension A. These are typically used on ICD-10-CM codes in Chapter 19, Injury, Poisoning, and Certain Other Consequences of External Causes and Chapter 20, External Causes of Morbidity. Let’s start with the 7th character extender.
7th Character Extender
There are three common ones (A, S, D) and more for fractures.
- A is used for active treatment
- D is for subsequent care
- S is for sequela, complications or conditions that arise as the direct result of a condition
- 7th characters are also used for fetus identification and in the comascale
X is a placeholder code.
If a 7th character is required, but the complete code is less than six characters, ICD-10-CM uses the letter x as a placeholder code to extend the code to six characters, allowing the 7th character to be added.
Placeholder Code Examples
Unspecified fall, W19 is a complete code. Naturally, we don’t want to use an unspecified code, but if we had to use W19, we need to add a 7th character. For active treatment, including the initial encounter, the complete code would be W19.xxxA.
X12 is the complete code for “contact with other hot fluids.” The initial encounter would be coded as X12.xxxA.
Would we put either of these codes in the first position on the claim form? Never! The injury is sequenced first.
I breathed a sigh of relief knowing that these xxxA searches weren’t x-rated (or x-rays, for that matter) but related to the placeholder code and 7th character extension.
Sometimes coding is funny.
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