R: Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunionĪccording to the guidelines, 7th character A (initial encounter) is used while the patient is receiving active treatment for the condition.Q: Subsequent encounter for open fracture type I or IIwith malunion.N: Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion.M: Subsequent encounter for open fracture type I or II with nonunion. J: Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing.H: Subsequent encounter for open fracture type I or II with delayed healing.F: Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing.: Subsequent encounter for open fracture type I or II with routine healing ,: Initial encounter for open fracture type IIIA, IIIB, or IIIC.B: Initial encounter for open fracture type I or II.These are other choices for fracture encounters that you will find throughout the chapter: P: Subsequent encounter for closed fracture with malunion.K: Subsequent encounter for closed fracture with nonunion.G: Subsequent encounter for closed fracture with delayed healing.The majority of fracture codes will have encounter types: Most categories in chapter 19 have a 7th-character requirement for each applicable code. There is also a designation for “unspecified,” but best practice would be to query the health-care provider for further documentation if laterality is not mentioned in the notes. Code descriptions include right and left designation, as well as bilateral designation when appropriate. What will we need to be aware of?Ī.Most of the changes made in ICD-10-CM were to chapter 19, “Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88),” because of the need to identify laterality and 7th-character extensions that indicate the type of encounter for the injury. We treat a lot of fractures in our urgent care clinic, and I understand there are changes for coding these in ICD-10-CM.
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