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I work at an orthopedic specialist facility and came across a patient who re-ruptured her Achilles and came in for a re-repair. It looks like we are using the CPT code 27650 and the ICD 10 is T81.32x. However, I'm not sure which 7th character to use? Do we treat this as a initial care (since it was re-injured two months ago), as subsequent care from her previous injury, or as a sequela?

Thank you for your help in advance!

If this is a new injury then I think you may have the incorrect code. I the patient did not follow thru after the original repair and it ruptured before it had a chance to heal then I can agree with that code. since this is the patients initial encounter for this re injury then the 7th character is an A.
Oh sorry, that was the secondary code that we were considering. The correct one was S86.011(A or S). But okay thank you! Is the 7th character always an A for a re-injury?
Two things.. first to answer your question .. empirically yes it would be an A but remember documentation of why the patient is there will dictate.
Second you would not use the S code for a new injury and the T code for the complication at the same time..
Answer the question..
\Is this a new injury? if yes then use the S code
Is this a disruption of the repair while the original injury was healing? if yes then use the T code.
Do not use both codes for the same injury. It is one or the other.