initial vs subsequent

mscountry

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The patient comes to see our medical doctor for an (EMC) emergency medical condition. They did not go to the ER or any other physician prior to us. This would be an initial encounter. Would it stay initial while the patient is treating until they are in a follow up or PRN status. We do EMC then the patient is sent to our rehab area. They would be initial for the eval, then stay initial until the patient is doing with that main treatment or would be become subsequent while in treatment?
 

mitchellde

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The patient comes to see our medical doctor for an (EMC) emergency medical condition. They did not go to the ER or any other physician prior to us. This would be an initial encounter. Would it stay initial while the patient is treating until they are in a follow up or PRN status. We do EMC then the patient is sent to our rehab area. They would be initial for the eval, then stay initial until the patient is doing with that main treatment or would be become subsequent while in treatment?
Not entirely correct. Go read the guidelines for injury an d initial, subsequent, and sequela. Diagnosis codes apply to the patient diagnosis not the encounter. The guidelines specify that initial is used for the active treatment of the injury regardless of whether it is your first encounter with the patient. Active treatment is say the repair of the fracture or suture of lacerations, or wound exploration. Once the active treatment is complete then it will become subsequent (healing phase). It could be your first encounter with the patient but the patient's subsequent encounter for care of the injury. The 7th characters A-S are assigned to which applies to the patient injury. When you send the patient to rehab it may be the rehab providers first encounter with the patient, however they are not providing active treatment for the injury. If the injury is still healing, then it would be for subsequent treatment of the injury. If the injury has healed and rehab is for residual issues due to the injury, such as muscle atrophy after a cast removal, then it is neither initial nor subsequent, it is sequela.
 
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