The revisions to International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) guidelines in 2015 provide guidance on the appropriate reporting of initial or subsequent encounters for injuries. Previously, the guidelines instructed that an initial encounter was reported for active treatment, which included evaluation and treatment by a new physician. The revised guidelines clarify that seventh character A is appropriately reported for any encounter for active treatment of a fracture, injury, or complication of care. Per ICD-10-CM guidelines, examples of active treatment are surgical treatment, emergency department encounter, and evaluation and continuing treatment by the same or a different physician. Because the guidelines specify that a subsequent encounter addresses the recovery or healing phase, the active treatment required for an initial encounter may be considered to be the visits, interventions, and assessments that are applied during the initial course of the injury to establish a pattern conducive to...

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