How to code an ICD-10-CM Sequela

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and if you didn't get it quite you're in

the Wheelhouse and I promise you will

always get it correct after this

aha outstanding all right so let me tell

you how I solved it all right so I'm at

my category t16 I know I'm in the

correct location I know that I have to

it told me

t16 is what it gave me not t16.2 I kind

of gave that away but laterality I have

to code for the correct ear and it's

left ear so left ear is t16.2 that's

four characters next to the code to the

left of the code we have a blue box and

that blue box says hey this needs to be

seven characters

so how are we going to make this four

character code seven characters yes the

seventh character extender boxes above

if we add that to the code it would be

invalid because the code the um

indicators in this box are only to be

placed at the seventh character

space

so this is how we coded all right

t16.2

is our subcategory

we have to place an X

one two three four five

characters

another X that's six

and finally our seventh character

extender a for initial encounter

in x marks the spot

okay coders who had aha moment

I love them

you know why because when you get it you

get it

right

and you remember it

right

outstanding okay now you know how to

code these seventh character

um extenders you know how to use the

extender box you know how to look up

codes you know how to identify First

listed code you all are rocking

but we've been taught we've been

skipping around the subject we

around this sequela

right

and we kind of talked about it and I

think in our lectures we didn't really

go in depth we didn't really explain it

as thoroughly as we should but I'm gonna

do that today

all right so sequela what is a sequela

better yet

does anybody know

what all of these movies have in common

type in the chat

do you know what these movies have in

common

yes yes yes

outstanding I love it they're saying

sequel happens after the first

um action movies someone said it was

cute

action movies I love it I love it I love

it all right these are sequels right

sequel sounds like sequela indeed they

have the same meaning just like a movie

sequel

there had to be a movie that came before

that came first

so if you're looking at Superman 4 there

had to be a Superman one two and three

right Die Hard 2 had a Die Hard One jaws

of Revenge had Jaws Caddyshack two came

after Caddyshack

so in other words

in order for a sequel to occur you have

to have an initial or something that

comes before it

and just like a sequel a movie sequel

a sequelae

can only occur after

an initial

illness or injury

don't let that marinate for a second

and while I'm doing that

I want to tell you did I name this young

lady what's her name

hmm I don't know we'll give her a name

Barbara Barbara with a broken leg

so Barbara is having a great time in

college she went on a hay ride fell off

the hayride broke her leg

and this broken leg

has a

what we call

a late effect

10 years later

Barbara walks with the limp

yeah

so the broken leg is the acute injury

it happened then

acutely

it happened first

but 10 years later she walked with a

limp and that limp is the sequelae

or the late effect

and so I just want you to remember

that the sequelae or the late effect is

the residual effect

after

the acute

phase or injury

and remember there's no time limit on

when a late effect code can be used

or that late effect indicator can be

used

and that's all I want to say

but I also want to draw your attention

to the guidelines because I started

telling you about the guidelines but I

want to show you

this is guideline number 10. General

coding guideline 10

sequeline

and sqa is a residual effect

after the acute phase of an illness

and or after it has terminated after

that acute phase has terminated there's

no time limit on when a sequelae code

can be used and the residual may be

apparent early such as cerebral

infarction so that's a stroke

or it may occur months or years later

like Barbara

all right and they give you some

examples of sequelae scar formation

resulting from a burn

we call that contracture as well

deviated

septum deviated septum due to nasal

fracture

infertility due to tubal occlusion from

old

tuberculosis so these are some examples

of

or sequela

and also

this is how you code it

coding of sequela

generally requires two codes sequenced

in the following order they're telling

you how to code it the condition or

nature of the sequela is sequenced first

then the sequela code is sequenced

second

right so the condition

or the nature of the sequela is

sequenced first followed by the sequela

code that seventh character s

is second

so let's go ahead and show you Barbara

so the condition that she has now that

limp

that is the condition or the nature of

the sequela

that will be sequence first

followed by

the sequela code

it would look like this

so if Barbara went to the doctor today

you would code her limp first

r26.89

followed by

that

injury code

s82.90 X

s

or sequela

are you with me coders

all right so I have an exercise all

right I just kind of want you to

understand sequelae

just a little more okay