October 22, 2015

Question:

I don’t understand the 7th character extension. Why don’t all codes get the 7th character extension?

Answer:

Good question! Only certain categories of codes have the 7th character extension requirement. For plastic surgery, the most common categories of codes include injuries (S codes) and other complications such as capsular contractures (T codes). The 7th character of A or B is for an initial encounter and used as long as the patient is receiving active treatment for the condition (e.g., consultation in the ER, surgery). The 7th character for subsequent encounters (e.g., D, G, K) is used when the patient has completed active treatment and is the recovery or healing phase of the injury.

*This response is based on the best information available as of 10/22/15.