Should we use initial or subsequent when a patient returns the same or next day to the ER for fracture care/issues?

Injury Extensions

Most categories in chapter 19 have seventh character extensions that are required for each applicable code, and most categories have three extensions (with the exception of fractures):

• A, Initial encounter
• D, Subsequent encounter
• S, Sequela

Extensions for initial encounters are used while the patient is receiving active treatment for the injury (e.g., surgical treatment, emergency department encounter, and evaluation and treatment by a new physician). The extensions for subsequent encounters are used for encounters after the patient has received active treatment of the injury and is receiving routine care for the injury during the healing or recovery phase (e.g., cast change or removal, removal of external of internal fixation device, medication adjustment, other aftercare and follow-up visits following injury treatment).