Understanding ICD-10 Codes for Fractures and Injuries

Understanding ICD-10 Codes for Fractures and Injuries

ICD-10 Logo from the CMS web site

As Physicians, Medical Billers and Medical Billing Companies are now aware of the new normal, the ICD-10 Compliance date of October 1, 2015 is now a reality.  Physicians Billing Service, since 1989, has been helping the industry’s best medical practices with compliance and cash flow.

The information below from the CMS, Centers for Medicare and Medicaid Services, provides essential insights on the use of the 7th character in the ICD-10-CM Code Structure.

The CMS has provided “examples of where the 7th character can be used include injuries and fractures, as illustrated in the following tables”:

Injuries & External Causes (Value & Description):

  • A:  Initial encounter
  • D:  Subsequent encounter
  • S:  Sequela

Fractures (Value & Description):

  • A:  Initial encounter for closed fracture
  • B:  Initial encounter for open fracture
  • D:  Subsequent encounter for fracture with routine healing
  • G:  Subsequent encounter for fracture with delayed healing
  • K:  Subsequent encounter for fracture with nonunion
  • P:  subsequent encounter for fracture with melanin
  • S:  Sequela

In the next Physicians Billing Service post, we will provide insights on the “dummy placeholder of “X” and where it is “used with certain codes to allow for future expansion and/or to fill out empty characters when a code contains fewer than 6 characters and a 7th character applies.”

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