ICD-10 7th Character: D vs S

October 19, 2015
Rick Gawenda

One of the most common questions I receive is when a 7th character is required on an ICD-10 code, how do I know if the 7th character should be the character “D” or character “S”? The use of the 7th character, in my opinion, is one of the most confusing for physical and occupational therapists as well as speech-language pathologists to understand. Below, I will answer the question of when to use “D” or “S” when a 7th character is required.

If the reason for therapy is a result of an injury and the ICD-10 code requires a 7th character and the patient is not receiving active treatment of the condition, should the visit for therapy have the 7th character as a “D” or “S”? To determine what the 7th character should be, we first need to understand the definition of 7th characters “D” and “S”.

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  1. So, if a patient had a fractured hand and is coming in for a splint and hand therapy, would that fall under D or A since it is still active treatment of the fracture?

    1. If you are stating the patient is still receiving active treatment from the therapist and the ICD-10 code requires a 7th character, you would use “a” as the 7th character.