# ICD-10-CM coding in ASC



## gsteeves (May 11, 2010)

Good Morning, My question is regarding the 7th digit being used in the injury section of the ICD-10-CM book.  A patient is being seen for surgery for acute acl tear, would the ASC put the 7th character as an A for initial encounter (only time seen at ASC) or D subsequent encounter as the physican doing the surgery has seen the patient in their office.

We are doing some practicing in our facility and would appreciate any imput.

Thanks,
Gail Steeves, CPC


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## mitchellde (May 11, 2010)

I would use the A as the 7th character given the definitions below from the ICD-10 coding guidelines.


Extension “A”, initial encounter is used while the patient is receiving active treatment for the injury. Examples of active treatment are: surgical treatment, emergency department encounter, and evaluation and treatment by a new physician.
Extension “D” subsequent encounter is used for encounters after the patient has received active treatment of the injury and is receiving routine care for the injury during the healing or recovery phase. Examples of subsequent care are: cast change or removal, removal of external of internal fixation device, medication adjustment, other aftercare and follow up visits following injury treatment.


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## mitchellde (May 11, 2010)

I would use the A as the 7th character given the definitions below from the ICD-10 coding guidelines.


Extension “A”, initial encounter is used while the patient is receiving active treatment for the injury. Examples of active treatment are: surgical treatment, emergency department encounter, and evaluation and treatment by a new physician.
Extension “D” subsequent encounter is used for encounters after the patient has received active treatment of the injury and is receiving routine care for the injury during the healing or recovery phase. Examples of subsequent care are: cast change or removal, removal of external of internal fixation device, medication adjustment, other aftercare and follow up visits following injury treatment.


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## gsteeves (May 11, 2010)

Thank you so much for the information!!


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