S62.513A (Displaced fracture of proximal phalanx of unspecified thumb, initial encounter for closed fracture)
compared with
S62.513G (Displaced fracture of proximal phalanx of unspecified thumb, subsequent encounter for fracture with delayed healing),
from the official CMS tabular data. S62.513A and S62.513G code the same injury at a different phase of treatment. MedCoder-derived
Displaced fracture of proximal phalanx of unspecified thumb, subsequent encounter for fracture with delayed healing
Same underlying diagnosis, different encounter phase.
The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.
Source: ICD-10-CM Official Guidelines, Section I.C.19.a
Can these codes be reported together?
Same injury, other encounter phase. S62.513A and S62.513G code the same injury at a different phase of treatment, set by the 7th character.
The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.
S00-T88 — Injury, poisoning and certain other consequences of external causes
S00-T88 — Injury, poisoning and certain other consequences of external causes
Definition
Displaced fracture of proximal phalanx of unspecified thumb, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S62.513A).
Displaced fracture of proximal phalanx of unspecified thumb, subsequent encounter for fracture with delayed healing is a billable ICD-10-CM diagnosis code (S62.513G).
7th character
The appropriate 7th character is to be added to each code from category S62
The appropriate 7th character is to be added to each code from category S62