In ICD-10-CM, an "x" placed in the fourth-, fifth-, or sixth-character place when needed to enable the seventh-character extender to remain in the seventh-character position is the:

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The "x" is known as the Placeholder character in ICD-10-CM coding. It is used to fill in empty character spaces to ensure that the seventh-character extender is correctly positioned in the seventh place.

In ICD-10-CM, an "X" Placed in the Fourth-, Fifth-, or Sixth-Character