A fracture diagnosis needs a seventh character for encounter type,…

Question

A fracture diagnosis needs a seventh character for encounter type, but the record is unclear whether this is the initial or a subsequent encounter. What should the coder do?

Accepted Answer

Obtain documentation of the encounter phase before assigning the seventh character rather than guessing — Seventh characters are not coin flips. If the chart does not say initial versus subsequent, do not guess—get the encounter phase documented first.

Answer

Default to initial encounter seventh character for any fracture treated in the hospital

Answer

Omit the seventh character and submit an incomplete ICD-10-CM code

Answer

Always use subsequent encounter because inpatient stays follow the ER visit

A fracture diagnosis needs a seventh character for encounter type, but the record is unclear whether this is the initial or a subsequent encounter. What should the coder do?

Short Explanation

Full Explanation