Injury codes are represented by the letter “A.”
A is used for active treatment of an injury, not only the initial encounter. Injuries require a seventh character extender in ICD-10 that defines the episode of care and, for fractures, the healing status of the fracture. The diagnosis code for the injury remains constant throughout the care of the injury, but the seventh character extender changes.
This significant change can be confusing because of the short descriptor of A—initial care, D—subsequent encounter, and S—sequela. When does initial care stop and subsequent care begin? The general guidelines that introduce the 2015 ICD-10 book clarified this: Don’t just use the seventh character solely on the first service with the patient; continue to use the A seventh character on follow-up visits while the patient is still receiving active treatment. Switch to D for subsequent care when the patient is receiving routine care in the healing or recovery phase.
When you see the A, don’t think initial, think A for Active.