Wiki Help....7 th digit -a/d

[NishaJ]

Patient was admitted with Femur neck fracture on right side, and physician performed an ORIF on 08/01/2016, and claim has billed with S72.001A for DOS 08/01/2016, and Patient has remained hospitalized for 08/02/2016 and discharged on 08/03/2016 .What will be the correct 7 th character for the DOS 08/02/2016 & 08/03/2016.

 

[danskangel313]

A is used for every encounter in which the patient is receiving active treatment. If the provider is checking the status of the fracture on 8/2 and 8/3, then those would constitute active treatment, so A would be appropriate. D is used when the active treatment has been completed and the patient is receiving routine care during the recovery or healing process.

https://www.aapc.com/blog/27096-initial-subsequent-sequela-encounter/

 

[mitchellde]

I disagree with the interpretation of my article. After the ORIF has been completed then you use subsequent. To check on the patient post operative, is subsequent whether the patient is inpatient or in the office.

 

[danskangel313]

I disagree. After the ORIF has been completed then you use subsequent. To check on the patient post operative, is subsequent whether the patient is inpatient or in the office.

Perhaps my post was unclear. "If the provider is checking the status of the fracture on 8/2 and 8/3, then those would constitute active treatment, so A would be appropriate." I should have re-worded the next sentence to read "D is used when the active treatment has been completed and the patient is receiving routine care during the recovery or healing process, so if that's what was being done on 8/2 and 8/3, then D would be appropriate."

Sorry for the confusion.

 

[mitchellde]

The active treatment was the ORIF. To see the patient the next day and e discharge day is subsequent.

 

[NishaJ]

Thank you all ...

 

[TheStephCode]

Did healing begin?

If yes, it is subsequent. The threshold between "A" and "D" is the point at which healing begins.

If not, for instance the patient still needs surgery before the healing process can begin or the patient's fracture still needs to be set, then they are still receiving active treatment and would be coded as initial, "A".