Wiki Help with initial, Subsequent, Sequela

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bill2doc

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My doctors work the ICU floor so they see patients every day for about 5 days.

For their first visit, they code S06.0X9A concussion,V43.52XA auto accident. Now on the second day, he would code S06.0X9D but what about the auto accident? Am I keeping the auto accident code on the claim for every day the doctor visits the patient all week only with D? I thought that the auto was only for the initial visit as they didn't have an auto accident everyday for five days. Heart Attack is similar. Normally we would code it once on the initial claim but not every day for five days as the patient didn't have a heart attack every day in the ICU. Obviously confused!!

Hope you can help and thank you so much in advance.

Lynn
 
ICD-10 CM is just different in many ways. Yes for as long as you code the injury you also code the external cause with the same initial subsequent or sequla standing. The use of the 7th character is dependent on the status of the injury not based on whether this is your providers first second third etc encounter.
For the acute MI, yes you do use the code for the acute MI for each encounter up through the 28th day after onset.
 
Thank you Debra. I was hoping you would answer! I tried a private message to you but your box is full. Thank you for clarifying. I will adj to include the auto accident everyday he sees the pt only with the D. Still trying to wrap my brain around Sequela. I imagine most fractures would be Sequela to the auto accident.....

On a separate note, what would you suggest for ICD-10 training? We are looking for both entry level and intermediate. Any suggestions would be helpful - PM if easier.

THANKS AGAIN!!!!!
 
Sequela is the issues that come after the injury has healed. So a fracture would not be sequla that is the injury, but a shortened limb to a severe crush fracture would be sequela from the injury and sequela from the accident.
As far as ICD-10 training... Where do you live?
 
Ahh got it. I live in Northern Ca. We are looking at local Adult schools but not sure what they are like. Some have a bit of coding knowledge and others are just starting. The office has high turn over so we never know what level might come in but we want to have options ready for them. Places they can go for both entry level icd-10 and intermediate icd-10. Most cases the doctors are providing the Dx but we need to make sure they still have an understanding. I have only been able to learn from webinars. Haven't found a local class that can be attending during the day or Saturday to help train.....
 
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