The seventh character in ICD 10 codes is not about how many times a patient has been seen, but rather about the stage of care they’re in. “A” is for active treatment, “D” is for follow ups, and “S” is for complications.
A – Initial Encounter. ‘A’ signifies that the patient is receiving treatment for the particular diagnosis for the first time. The confusion is faced when the patient visits the clinic for the continued treatment of the same diagnosis.
All ICD 10 codes will begin with one of the following letters of the alphabet; the alpha characters are not case sensitive. The most commonly reported diagnoses for chiropractic are likely to begin with an "M" or an "S".
The assignment of the 7th character is dependent on whether the patient is receiving active initial treatment of the injury and not whether the provider is seeing the patient for the first time. These are patient diagnosis codes not provider encounter codes.
Learn ICD 10 CM coding with a focus on 7th characters A, D, and S for injuries. Includes guidelines, examples, and practice scenarios.
If you read the guidelines in Chapter 19 (Injury, Poisoning, and Certain Other Consequences of External Causes) you will see that the seventh character “A” means initial encounter and is used for each encounter where the patient is receiving active treatment for the condition.
"A" (Initial encounter) Initial encounter is defined as the period when the patient is receiving active treatment for the injury, poisoning, or other consequences of an external cause. An "A" may be assigned on more than one claim.
The character ‘A’ is not required for the ICD 10 equivalent codes for low back pain or sciatica. These codes are found in Chapter 13 (M00 M99) and the instructional notes do not list a seventh character requirement.
In the ICD 10 CM coding system, the "A" as the 7th character stands for "initial encounter." This designation indicates that the patient is receiving initial active treatment for their condition, which is crucial for coding and billing purposes in healthcare.
Codes in the ICD 10 CM code set can have anywhere from three to seven characters. The more characters there are, the more specific the diagnosis. The first character is always alpha (i.e., a letter), but characters two through seven can be either alpha or numeric. Let’s take a look at an example.
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