Wiki Therapy coding

[flaw]

I was wondering if anyone could direct me for injury coding for pediatrics in ICD-10 for therapy only patients. We currently assign the diagnosis on the initial visit and these diagnoses carry through the certification period which are up to a year. How would we accomodate the initial, subsequent difference? I am not having any luck in finding documentation addressing this. It seems clear what to use in the physician setting. Thanks in advance.
Fran

 

[mitchellde]

I was wondering if anyone could direct me for injury coding for pediatrics in ICD-10 for therapy only patients. We currently assign the diagnosis on the initial visit and these diagnoses carry through the certification period which are up to a year. How would we accomodate the initial, subsequent difference? I am not having any luck in finding documentation addressing this. It seems clear what to use in the physician setting. Thanks in advance.
Fran

You will need to be more specific in your question. If you are referring to physical therapy, then most of the time you will be using the 7th character for subsequent or sequela, it just depends on the circumstance.

 

[flaw]

Debra, Thanks for your response. Do you agree that the Initial "A" character would never be assigned to a new patient receiving therapy? I was thinking we had to use the Initial for the first visit and then subsequent for the visits after. It makes more sense that it would be subsequent.
I posed a question to a coding instructer regarding new patients seen in our Traumatic Brain Injury clinic by physicians which are mostly referred by ER or other PCP and was told if its a new provider, then we would use the 7th character as "A". I am not clear on these. What would we use for established TBI patients that have re-injuries ???? Any advise from my fellow coders?
Thanks

 

[mitchellde]

The diagnosis belongs to the patient and at no time reflects the provider encounter. The 2015 ICD-10 coding guidelines clarified initial.
While the patient may be seen by a new or different provider over the course of treatment for an injury, assignment of the 7th character is based on whether the patient is undergoing active treatment and not whether the provider is seeing the patient for the first time.