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Dreaded a vs d suffix

cgaston

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Choose "A" whenever there is active treatment occurring during the visit. Otherwise, choose "D".
 

cgaston

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You flip to D when the patient is still healing but you are not providing any more treatment.


So if we use a fracture as an example: you would use the "A" for the visit where they set the fracture. The doctor sees the patient a few weeks later and sees that the fracture is healing. Since the doctor doesn't have to provide any further treatment for the fracture (but the patient still has the fracture since it isn't completely healed) you use "D".

ETA: say the fracture ends up as a malunion. When they try to correct it you would choose the "A" because they are actively trying to fix the problem. (A=action)


Hope that helps!
 
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erjones147

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To piggyback on cgaston's answer, it is possible for a condition to move from A to D and back to A and then back to D, depending on what is being done and which provider is performing the service
 

SydneyO

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I have no idea if this is going to help, but how I remember it is A= Active and D=Done.
So like the other people said, A is when the patient is seeking Active care for their condition. I remember D as the hard work is Done, the condition is mostly resolved, and the patient is now in the recovery phase following active treatment. In this phase, the patient will come in for things like follow up visits, follow up xrays, hardware removal, etc. The doctor will be making sure that there is nothing serious still going on with that old injury and that it is healing properly.
Hope this helps. Good luck!
 

mitchellde

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To piggyback on cgaston's answer, it is possible for a condition to move from A to D and back to A and then back to D, depending on what is being done and which provider is performing the service
No that is not true. You would not move back and forth depending on the provider. These are patient diagnosis codes so it is all about the patient and the status of their injury. If this is the first encounter with a provider for an injury that had already been actively treated in the ER and your provider is only checking on the injury then the 7th character is a D not an A. And it will stay a D until it is healed with residual issues or it has a complication and becomes a complication code. The diagnosis codes are all about the patient.
 

erjones147

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If an ER doc codes a broken leg as an A, then the PCP codes the follow-up as a D but refers to an orthopedist for resetting a malunion, that orthopedist is going to switch back to an A
 

mitchellde

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That is incorrect. The Ortho treating the malunion will use a P or Q or R as the 7th character for subsequent encounter for malunion. Or a K, M, or N for treating a nonunion.
 
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REGINALD068

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Ok...now I'm confused with the last comment from Debra. In any case, if a patient is seen for ankle sprain, only an exam was performed, do I use D given there was no active treatment?
 

mitchellde

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the example was a pt is treated in the ER for a fracture and they use the A, then the patient is followed up with a different provider and they use the same injury code with a D, this is so far correct.
the post went on to state......." but refers to an orthopedist for resetting a malunion, that orthopedist is going to switch back to an A " which is incorrect. A follow visit to treat a malunion is coded using the 7th character for the subsequent visit for malunion or non union which is the P, Q, R or K, M, or N depending on whether the original injury was closed or open or open type III.
hopefully that helps to clear up the confusion.
now your question was a diagnosed ankle sprain for which no treatment was prescribed.. remember active treatment is not always going to be as overt as surgery. If the provider told the patient to limit activity and elevate and ice the injury that still qualifies as active treatment if this is the initial presentation by the patient to obtain active treatment and not a follow up from the ER.
 

REGINALD068

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Thank you everyone for your insight. All comments have been very helpful. One question though: If a Doc takes xrays, is that considered active treatment? I wouldn't think so.......
 
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