Certified Medical Assistant (CMA AAMA)Administrative: Billing, Coding and SchedulingMedium
A medical assistant is coding a patient's chart for a fracture sustained in a fall, and the physician documents this is the patient's first visit for active treatment of the fracture. Which ICD-10-CM 7th character extension should be appended to the injury code?
- AG – delayed healing
- BS – sequela
- CD – subsequent encounter
- DA – initial encounter
Show answer & explanationAnswer & explanation
Correct answer: D. A – initial encounter
In ICD-10-CM injury coding, the 7th character 'A' (initial encounter) is used while the patient is receiving active treatment for the condition, such as surgical care, emergency department care, or evaluation by a new physician; 'D' is used for subsequent/healing encounters and 'S' for sequela (late effects).
Why the other options are wrong
- A. G is not a valid 7th character option for fractures.
- B. S is used for complications/conditions arising as a direct result of an injury, after the acute phase.
- C. D is used for follow-up visits during the healing phase, not the first treatment visit.
7th Character Extension
An ICD-10-CM coding element required for injury, poisoning, and certain other codes that specifies the episode of care: A (initial), D (subsequent), or S (sequela).
- A = active treatment (initial encounter)
- D = routine healing/recovery phase (subsequent)
- S = sequela, a late effect after the acute phase resolves
Memory trick: A is for Active treatment, D is for Down the road, S is for Sequela