AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2015 Issue 3; Clarifications

Use of Activity Codes for Subsequent Encounters

One of the examples on the use of the 7th character published in the First Quarter 2015 issue of Coding Clinic page 8 indicated that “the activity code is not assigned again as activity codes are used only at the initial encounter for treatment.” We understand that this is consistent with the Official Coding Guideline I.C.20.a.8.c. However, there is also guideline I.C.20.a.2 which states “…assignment of the 7th character for external cause should match the 7th character of the code assigned for the associated injury or condition for the encounter.”  Why wasn’t the activity code assigned for the example in the First Quarter 2015, such as the patient who presents to the emergency department (ED) after an injury playing lacrosse and then follows up with the local orthopedist for treatment of the fracture? In that example, the patient was still receiving active treatment with the local orthopedist and the 7th character “A, initial encounter” was assigned to the injury code, but the activity code was only assigned for the ED encounter. Does “initial encounter” in the context of the 7th character for injury codes have a different meaning from “initial encounter” as used in the application of the activity codes? ...

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