Wiki M80.0-X- (A or D)

[mcdream]

CC: Osteoporosis
DX: Osteoporosis with current pathological fracture
Provider assigned: M80.0-XA; osteoporosis with current pathological fracture, initial encounter.

Question: The reason for the encounter with the endocrinologist was for osteoporosis NOT for treatment of the fracture, therefore wouldn’t the correct code be M80.0XD; osteoporosis with current pathological fracture, subsequent encounter NOT M80.0-XA; osteoporosis with current pathological fracture, initial encounter?

*Assignment of the 7th character pertains to the encounter status for fracture NOT encounter status for osteoporosis.

TIA

 

[mitchellde]

Assignment of the 7th character depends on active treatment of the injury. If the fracture has been treated by a provider the 7th character goes to the D for all providers .

 

[sarab86]

A vs D has always been explained to me and by the AANS that A is only for the visit that initially diagnosis the injury/fracture or surgery because that would be the initial visit for the global care. We are neurosurgery so usually the ER doc or the referring doc billed the A because these patients come to us already knowing they have a fracture. We will only use the A when we take the patient in for a kypho.

 

[RyanRaichCPC]

I agree with Debra. A is for when the condition is actively being treated. You can go from using a D back to an A if a new course of treatment is being rendered.