Wiki Episode of Care

[gherimicheleCPC]

I am having a discussion with another coder and I just want to see if anyone else knows this answer..... the character D is used for subsequent encounter even if your provider did NOT see the patient initially right? Lets say the patient was being treated by another provider and then started seeing you for the fracture My billing would start with a D right?

 

[mitchellde]

It is based on the injury and the treatment of the injury not on whether this is your providers first or second encounter. If the initial provider did not/ could not treat the fractur and they are sent to your provider for fracture treatment then it is initial active treatment of the fracture. If the fracture was treated sufficiently by other provider and the patient is sent to you for fracture management after treatment then it is subsequent treatment of the fracture and it would be a D,E,F,G,H,J,K,M,N,P,Q, OR R.

 

[Samantha.Prince]

D- subsequent encounter

Look in the guidelines under chapter 13, c. Coding of Pathologic Fractures and/or chapter 19, a. Application of 7th Characters in Chapter 19

The assignment of the 7th character is based on the treatment stage not who saw the patient.

"Examples of subsequent care are: cast change or removal, an x-ray to check healing status of fracture, removal of external or internal fixation device, medication adjustment, other aftercare and follow up visits following treatment of the injury or condition."