Guidelines › Pathological fractures: the 7th character

Pathological fractures: the 7th character

Official text from the FY2027 ICD-10-CM Official Guidelines for Coding and Reporting. The wording is quoted exactly.

Guidelines I.C.13.c

“7th character A is for use as long as the patient is receiving active treatment for the fracture.”

“assignment of the 7th character is based on whether the patient is undergoing active treatment and not whether the provider is seeing the patient for the first time.”

“7th character D is to be used for encounters after the patient has completed active treatment for the fracture and is receiving routine care for the fracture during the healing or recovery phase.”

Where this applies

936 billable codes. Source: FY 2027 ICD-10-CM Official Guidelines for Coding and Reporting, effective October 1, 2026. Full Guidelines (PDF, CMS)

The Guidelines are the authority for assigning codes, and following them is required under HIPAA. This page quotes them for convenience and is not a substitute for the official document. See the Terms and Disclaimer.