Wiki ICD-10 Initial or subsequent for impatient services

[MichelleAKing]

When a patient is picked up in the hospital and is hospitalized with injuries for quite some time, when is the cutoff point to NOT use "initial " encounter for physician hospital visits and to start using "subsequent" ICD-10 codes for his injuries? This particular patient has been hospitalized for the past few months and is still in recovery and healing for his injuries. Any insight is appreciated.
Thank you.

Michelle

 

[shaill]

Examples of when to use "subsequent encounter" are directed at the healing or recovery phase of the fracture care. A clue to signal this type of routine care during the healing or recovery phase would include cast change/removal, imaging to check the status of the fracture (healing status), or even removal of fixation devices.

I hope this helps.

Sally Haill, CPC
AHIMA Approved ICD-10-CM/PCS Trainer

 

[MichelleAKing]

Thank you Sally. Here is an example of what I mean -

Example: A patient is admitted with a neck fracture, a lacerated liver and a pneumothorax. He is in the hospital for two months. The physician sees him every day and he is still in recovery. These particular injuries cannot be casted etc. At what point do you determine that the encounter changes from initial to subsequent? Is it after the initial consultation? Or for the whole time he is hospitalized for these injuries?
Thank you again -
~Michelle