I work as a coder in homecare/DME/Pharmacy. I would like advice as to if the orthopedic aftercare codes should be used when physical therapy is provided in the home. Most of the patients that we see are due to injuries and very few are congenital issues, etc. Therefore, the codes used are in the S00-T88 Injury, poisoning and certain other consequences of external causes section.

I found this statement: "7th character “D” subsequent encounter is used for encounters after the patient has received active treatment of the condition and is receiving routine care for the condition during the healing or recovery phase. Examples of subsequent care are: cast change or removal, an x-ray to ICD-10-CM check healing status of fracture, removal of external or internal fixation device, medication adjustment, other aftercare and follow up visits following treatment of the injury or condition. "The aftercare Z codes should not be used for aftercare for conditions such as injuries or poisonings, where 7th characters are provided to identify subsequent care. For example, for aftercare of an injury, assign the acute injury code with the 7th character “D” (subsequent encounter)".

I actually do the coding for DME and Home Care Pharmacy and ‘non-coder’ nurses are doing the home care coding. I am probably overstepping, but I like to point out issues when I see them. I thought that my advice would be well received, but it wasn’t.

Anyway, is the above statement is the evidence that I provided to these nurses.

Thanks so much for your input!