Wiki AK's and X32 add on code, ICD 10

[heidiwhiteman]

when coding for Actinic Keratosis including the add on code of X32. How do I chose if the visit is A=initial encounter, D= subsequent visit or S= sequela?. I'm confused because if the AK is caused by sunlight it would seem that it should be sequel, but if this is the first time being seen for this issue, should it be initial encounter. Any feedback is appreciated.

Thanks

 

[ckeeney]

This is an initial encounter. X32 is the external cause of the condition being treated. Sequelae by definition are after effects from the condition, not the cause (source). By sequencing instructions, the coding is L57.0, X32.xxxA.