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Dreaded a vs d suffix

  1. #1
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    Monmouth County
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    Default Dreaded a vs d suffix
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    I've always struggled with this. Can someone give me a simple way to remember when to appropriately use the A/D?

  2. #2
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    Choose "A" whenever there is active treatment occurring during the visit. Otherwise, choose "D".
    Carol Gaston CPC CRC CPCO

  3. #3
    Location
    Monmouth County
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    Hi Carole
    I still don't get it. So when do I flip to D?

  4. #4
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    You flip to D when the patient is still healing but you are not providing any more treatment.


    So if we use a fracture as an example: you would use the "A" for the visit where they set the fracture. The doctor sees the patient a few weeks later and sees that the fracture is healing. Since the doctor doesn't have to provide any further treatment for the fracture (but the patient still has the fracture since it isn't completely healed) you use "D".

    ETA: say the fracture ends up as a malunion. When they try to correct it you would choose the "A" because they are actively trying to fix the problem. (A=action)


    Hope that helps!
    Last edited by cgaston; 10-17-2018 at 11:13 AM.
    Carol Gaston CPC CRC CPCO

  5. #5
    Location
    Monmouth County
    Posts
    66
    Default
    Got it!!!
    Thanks for the clarity.

  6. Default
    To piggyback on cgaston's answer, it is possible for a condition to move from A to D and back to A and then back to D, depending on what is being done and which provider is performing the service

  7. #7
    Location
    Monmouth County
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    66
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    Yes.....I understand flipping back and forth depending on what's happening with the patient.

  8. #8
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    I have no idea if this is going to help, but how I remember it is A= Active and D=Done.
    So like the other people said, A is when the patient is seeking Active care for their condition. I remember D as the hard work is Done, the condition is mostly resolved, and the patient is now in the recovery phase following active treatment. In this phase, the patient will come in for things like follow up visits, follow up xrays, hardware removal, etc. The doctor will be making sure that there is nothing serious still going on with that old injury and that it is healing properly.
    Hope this helps. Good luck!

  9. #9
    Location
    Columbia, MO
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    Quote Originally Posted by erjones147 View Post
    To piggyback on cgaston's answer, it is possible for a condition to move from A to D and back to A and then back to D, depending on what is being done and which provider is performing the service
    No that is not true. You would not move back and forth depending on the provider. These are patient diagnosis codes so it is all about the patient and the status of their injury. If this is the first encounter with a provider for an injury that had already been actively treated in the ER and your provider is only checking on the injury then the 7th character is a D not an A. And it will stay a D until it is healed with residual issues or it has a complication and becomes a complication code. The diagnosis codes are all about the patient.

    Debra A. Mitchell, MSPH, CPC-H

  10. Default
    If an ER doc codes a broken leg as an A, then the PCP codes the follow-up as a D but refers to an orthopedist for resetting a malunion, that orthopedist is going to switch back to an A

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