Subsequent vs. Sequela

LKaf7

Networker
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Hello,

Pt came in for pre-op clearance by their PCP for knee surgery. Injured knee playing soccer. Provider used DX S83.241S (medial meniscus tear, right, sequela). Would this be considered a subsequent encounter? I get so confused between subsequent and sequela and how everything should be coded and would like to give proper feedback to the providers. Any tips are appreciated!

thank you!
 

thomas7331

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I'm not an ortho coding expert, but per my understanding this should be coded S83.241A - if the surgery has not taken place yet, this is still the initial phase of the injury. S83.241D for subsequent is used in the healing phase, which would be after the surgery. Sequela is only for the late effects, so for example if the patient returned after the initial treatment was completed and had scar tissue or other complications and needed additional treatment, then S83.241S would apply at that point.
 

Lynda Wetter

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Local Chapter Officer
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In my opinion this would be A as well. Per guidelines the A identifies the condition still being under ACTIVE treatment.
See chapter 19 guideline C.19.a
 
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