The Centers for Medicare & Medicaid Services and the National Center for Health Statistics (NCHS) have published the 2015 guidelines for coding and reporting using International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). These guidelines will be effective October 1, 2015, when the ICD-10-CM code set is implemented and are important to know in anticipation of implementation. The new guidelines may be reviewed in full on or downloaded from the NCHS Web site at

Most significantly, the guidance for reporting an initial encounter for fractures (pathologic or traumatic), injury, or complication of care has been revised to emphasize the nature of the visit as active treatment versus subsequent care rather than the encounter being the first for care of the condition by the physician or other provider. This instruction guides selection of seventh characters A and D.

The guidelines now state that seventh character A,...

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