There seems there is some confusion regarding Late Effects and ICD-10 Sequelas.     LATE EFFECTS In ICD-9 we used the term "late effect" to indicate a chronic or residual condition or a complication of an acute condition that occurs after the acute phase of a disease, illness or injury has passed." Late effects could also be caused indirectly by the treatment for a disease or other condition. There is no time limit on when a late effect can occur; the residual condition may come directly after the disease or condition, or years later.  In ICD-10, instead of using the term "late effect" the term "sequela" (singular) or "sequelae" (plural) is used to describe these diseases or conditions.  FRACTURE AFTERCARE CODING    Most aftercare is coded with Z codes but this is not the case with injury aftercare. For aftercare of an injury, coders should assign the acute injury code with the appropriate seventh character. For example, when coding a closed fracture, coders must add one of the following seventh characters to each code: A:  Initial encounter for frature D:  Subsequent encounter for fracture with routine healing G:  Subsequent encounter for fracture with delayed healing K:  Subsequent encounter for fracture with nonunion P:  Subsequent encounter for fracture with malunion S:  Sequela DEFINITIONS: 1. Intitial encounter (A) is to be used while the patient is receiving active treatment for the injury. This includes: a. Surgical treatment b. Emergency Depatment encounter c. Evaluaton and treatment by a new physician 2. 7th character extensions for subesquent encounter (D, G, K, and P) denote encounters after the patient has received active treatment of the injury and now receives routine care for the injury during the healing or recovery phase.  These types of encounters inc…