Chapter-specific coding guidelines for physician coding and reporting are provided in Section IV of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). It is important that these guidelines be reviewed carefully prior to implementation of ICD-10-CM because they are considerably different from ICD-9-CM coding guidelines for fracture care and aftercare.

The initial encounter for active treatment of the fracture (eg, surgical treatment, emergency department encounter, evaluation and treatment by a new physician) is reported using seventh character code A, B, or C. Seventh character codes A, B, and C are also used to identify the initial encounter for the patient who delayed seeking treatment for an open or closed fracture.

Seventh character codes D, E, and F are used to report routine follow-up fracture care (eg, cast change or removal, removal of external or internal fixation device, medication...

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