Q&A: Determine ICD-10-CM Seventh Character for Nonunion

Q: A patient fractured all metatarsals last year and had open reduction and internal fixation. The patient now has a nonunion of the fracture sites and is going back to the OR for an amputation. What would be the appropriate ICD-10-CM seventh character to report?

A: A nonunion is considered a sequela. Therefore, as long as the amputation is directly connected to the nonunion in the documentation, the seventh character should report this fact.

Editor’s note: Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, AHIMA-approved ICD-10-CM/PCS trainer, of Safian Communications Services in Orlando, Florida, answered this question. She is a senior assistant professor who teaches medical billing and insurance coding at Herzing University Online in Milwaukee. Email her atssafian@embarqmail.com.

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