Coding Diagnosis in Fracture.
Fracture coding can be a challenge for both physicians and coders, however knowing how ICD-10 delineates initial and subsequent visits is key.
Although the terms initial and subsequent, relating to fracture care, were used in ICD-9-CM, they have new meaning in ICD-10-CM. Basically, neither term has little to do with whether a provider has previously seen or treated the patient for the condition.
Initial does not equate to a first visit ? although, it may be the first time the provider has seen the patient for the fracture. Initial is interpreted as active treatment. When the visit is for the purpose of deciding what treatment is required to repair the fracture, it is an initial encounter. Likewise, when the visit results in a changed active plan of care, it is an encounter.
Subsequent equates to aftercare treatment and may be appropriate to code even when it?s the provider?s first time seeing the patient. For example, if the first time a provider sees the patient for the fracture is to continue post-treatment care, the initial visit is a subsequent fracture encounter.
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