Physician Practice

Reporting aftercare codes in ICD-10-CM

Physician Practice Insider, September 8, 2015

Aftercare, or Z codes, should not be used for conditions found in Chapter 19 of the ICD-10-CM Manual, such as injuries or poisonings where the seventh character identifies subsequent care. For example, for the aftercare of an injury, assign the acute injury code with the seventh character D (subsequent encounter).

If the condition warrants a seventh character assignment of S (sequel), coders will also have to assign two codes—one code for the injury and one code for the sequela itself. The coder assigns the S designation only to the injury code, not the sequela code.

The seventh character S identifies the injury responsible for the sequela. The type of sequela (e.g., scar) will be sequenced first, followed by the injury code. Per the ICD-10-CM Official Guidelines for Coding and Reporting, a sequela is the residual effect after the acute phase of an illness or injury has ended.

A sequela can be apparent within hours, days, months, or even years after the illness or injury has occurred, with no time limit on when it can be coded. Assign the external cause code with the appropriate seventh character for each encounter in which the physician is treating an injury or condition.

This tip is adapted from “Coding Clinic defines ICD-10-CM seventh character" in the August issue of Briefings on APCs.

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