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?

  1. AG – delayed healing
  2. BS – sequela
  3. CD – subsequent encounter
  4. DA – initial encounter
Show answer & 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

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