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Wiki Question about sequela vs active treatment for mechanical breakdown

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AlaskanCoder

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We are having a discussion about the codes under sub-category T82.22 for "Breakdown (mechanical) of biological heart valve graft". If patient has regurge or insufficiency due to failing bioprosthesis and is scheduled for replacement, is this an initial encounter (active treatment) or is it sequela? My coworker and I feel it is sequela. But, if that is the case, what justifies the use of A for the 7th character?

Thank you, in advance, we truly appreciate your comments.

Karen
 
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