Wiki Initial vs. subsequent encounter

[maryek28@outlook.com]

Sometimes we see patients from the ER for follow-up wound care. For example a patient got stitches and bandages at the ER for an arm laceration, then was seen by us a few days later for a wound check and bandage change. Is this a subsequent encounter since the patient initially got care at the ER for the injury? Our provider is not employed by or affiliated with the hospital if that makes a difference.

 

[mitchellde]

Remember this is the patient,s diagnosis not the providers so the diagnosis represents the patient not the physician encounter. This is patients encounter to receive subsequent care for the injury after successful active care in the ER. So it is subsequent even though it is yours providers first encounter to see this injury. If your provider needs to complete or extend active treatment for the patient injury then it is still active treatment for the patient and would receive the A. Example would be continued debridemnt of a Wound that was not closed due to extensive contamination. If the provider is continuing to debride and explore this wound after treatment in the ER then it is still active treatment. However if the laceration was repaired in the ER then when the patient follows up with the PCP the wound is healing and it is subsequent care. If the wound is infected or has a disruption you would use a complication of trauma wound code with the 7th character A.

 

[maryek28@outlook.com]

Thank you so much, this makes a lot more sense now!