Home Health Coding and OASIS Expert

When it comes to fractures, your Chapter 19 seventh character options expand to allow you to indicate the type of fracture, the Gustilo classification, and whether:

• the encounter is initial or subsequent;
• the fracture is open or closed;
• there is delayed healing, nonunion, or malunion present; or
• there is a sequela present.

For example, codes in category S52 (Fracture of forearm) must include one of the following seventh characters:

A — initial encounter for closed fracture

B — initial encounter for open fracture type I or II/initial encounter for open fracture NOS

C — initial encounter for open fracture type IIIA, IIIB, or IIIC

D — subsequent encounter for closed fracture with routine healing

E — subsequent encounter for open fracture type I or II with routine healing

F — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing

G — subsequent encounter for closed fracture with delayed healing

H — subsequent encounter for open fracture type I or II with delayed healing

J — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing

K — subsequent encounter for closed fracture with nonunion

M — subsequent encounter for open fracture type I or II with nonunion

N — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion

P — subsequent encounter for closed fracture with malunion

Q — subsequent encounter for open fracture type I or II with malunion

R — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion

S — sequela.