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7th character - malunion - 1st office visit

  1. #1
    Default 7th character - malunion - 1st office visit
    Medical Coding Books
    Good Morning:

    If a patient presents to an ortho office with a malunion of the radial shaft....AND is the 1st visit for the patient to this office....AND

    ................the patient has not had ANY prior treatment of any kind for this fracture.....

    would I use 7th character A?

    If the patient has had treatment with another physician for a fracture, then sees a new practice altogether and had a malunion...would I then use 7th character K as the patient has previously had treatment even though it was with a different physician.

    Many thanks to whomever can help!

  2. Default
    I believe you would use "A" as the 7th character in the instance you are talking about.

    The "A" is used during "active treatment" of the injury, whether or not the patient's already been treated by another provider for the same injury. When the active treatment is completed, and the case goes into "healing phase", then you'd use the "D".

    There is specific information regarding malunion/nonunions in the ICD-10 book. Look at the Guidlelines for Chapter 19 - Section c, Paragaph 1. As a matter of fact, the example they give sounds very similar to your question.

    There is also a good, relatively recent, article on this subject at:

    I hope this helps.

    - Mike, CPC, CPB

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