Mary Jo Bowie MS, BS, AAS, RHIA, RHIT

Injury, Poisoning, and Certain Other Consequences of External Causes CHAPTER 24 Injury, Poisoning, and Certain Other Consequences of External Causes

Injury, Poisoning and Certain Other Consequences of External Causes—S00-T88 Injury, poisoning, and certain other consequences of external causes are reported from Chapter 19 of ICD-10-CM. Codes from this chapter are used to report injuries and poisonings. The external cause of the morbidity is reported with a secondary code(s) from Chapter 20 of ICD-10-CM.

Organization of Chapter 19 of ICD-10-CM The blocks are organized with codes for injuries first followed by the codes for poisonings and then other complications. The injury codes begin with the head and work their way down the body.

Terminology Traumatic fractures are reported within this chapter of ICD-10-CM. There are various types of fractures: Open Compound Closed Complete Simple

Closed Fractures Closed fractures are classified as: Comminuted Compressed Depressed Fissured Greenstick Impacted Spiral Stress

Traumatic Fractures When reporting traumatic fractures in ICD-10-CM the codes are: Specified by site Assigned an appropriate 7th character extension Reported as to laterality

Injuries Blocks The blocks of codes for injuries are as follows: S00-S09—Injuries to the head S10-S19—Injuries to the neck S20-S29—Injuries to the thorax S30-S39—Injuries to the abdomen, lower back, lumbar spine, pelvis, and external genitals

Injury Blocks (cont.) S40-S49—Injuries to the shoulder and upper arm S50-S59—Injuries to the elbow and forearm S60-S69—Injuries to the wrist, hand and fingers S70-S79—Injuries to the hip and thigh S80-S89—Injuries to the knee and lower leg S90-S99—Injuries to the ankle and foot T07—Injuries involving multiple body regions T14—Injury of unspecified body region

Remaining Blocks Within the Chapter T15-T19—Effects of foreign body entering through natural orifice T20-32—Burns and corrosions T33-T34—Frostbite T36-T50—Poisoning by adverse effect of and underdosing of drugs, medication, and biological substances

Additional Blocks T51-T65—Toxic effects of substances chiefly nonmedicinal as to source T66-T78—Other and unspecified effects of external causes T79—Certain early complications of trauma T80-T88—Complications of surgical and medical care, NEC

Official Guidelines for Coding and Reporting The guidelines address the following: Application of 7th Characters in Chapter 19 Coding of injuries Coding of traumatic fractures Coding of burns and corrosions

Official Guidelines for Coding and Reporting (cont.) Adverse effects, poisoning, underdosing, and toxic effects Adult and child abuse, neglect, and other maltreatment Complications of care

Points to Remember Most categories in Chapter 19 have 7th character extensions. When coding injuries, assign separate codes for each injury unless a combination code is provided. A fracture not indicated as open or closed should be coded as closed.

More Points Current burns are classified by depth, extent, and by agent. No additional external cause code is required for poisonings, toxic effects, adverse effects, and underdosing codes. Query the medical record to determine if abuse or neglect is documented as confirmed or suspected.

Final Point Code assignment for complications of care is based on the provider’s documentation of the relationship between the condition and the procedure.

Coding Practice Select the code for the following: Initial encounter for Torus fracture of lower end of right ulna

Coding Practice Solution Main term to reference in index: Fracture Modifying term: Ulna, then lower end, then torus Code Assignment: S52.621A