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

External Causes of Morbidity CHAPTER 25 External Causes of Morbidity

External Causes of Morbidity—V01-Y99 External causes of morbidity are reported from Chapter 20 of ICD-10-CM. Codes from this chapter are used as secondary codes to report the causes of morbidity.

Transport Accidents—V00-V99 Transport accidents are organized according to the following blocks: V00-V09—Pedestrian injured V10-V19—Pedal cyclist injured V20-V29—Motorcycle rider injured V30-V39—Occupant of three-wheeled motor vehicle injured V40-V49—Car occupant injured

Transport Accidents (cont.) V50-V59—Occupant of pickup truck or van injured V60-V69—Occupant of heavy transport vehicle injured V70-V79—Bus occupant injured V80-V89—Other land transport accident

Final Transport Accidents V90-V94—Water transport accident V95-V97—Air and space transport accident V98-V99—Other and unspecified transport accidents

Other External Causes of Accidental Injury—W00-X58 This block is divided as follows: W00-W19—Slipping, tripping, stumbling, and falls W20-W49—Exposure to inanimate mechanical forces W50-W64—Exposure to animate mechanical forces

Code Range W00-X58 (cont.) W65-W74—Accidental non-transport drowning and submersion W85-W99—Exposure to electrical current, radiation, and extreme ambient air temperature and pressure X00-X08—Exposure to smoke, fire, and flames

Final Codes for W00-X58 X10-X19—Contact with heat and hot substances X30-X39—Exposure to forces of nature X52, X58—Accidental exposure to other specified factors

Remaining Blocks Within the Chapter X71-X83—Intentional self-harm X92-Y08—Assault Y21-Y33—Event of undetermined intent Y35-Y38—Legal intervention, operations of war, military operations, and terrorism Y62-Y84—Complications of medical and surgical care Y90-Y99—Supplementary factors related to causes of morbidity classified elsewhere

Official Guidelines for Coding and Reporting The guidelines address the following: General external cause coding guidelines Place of occurrence guidelines Activity code

Official Guidelines for Coding and Reporting (cont.) Place of occurrence and activity code used with other external cause code If the reporting format limits the number of external cause codes Multiple external cause coding guidelines

Official Guidelines for Coding and Reporting (cont.) Child and adult abuse guidelines Unknown or undetermined intent guidelines Sequelae (Late Effects) of external cause guidelines Terrorism guidelines External cause status

Points to Remember External causes of morbidity codes are secondary codes. These codes can be used in any healthcare setting. External cause codes are not required for reporting to some third-party payers, for example, CMS.

More Points External cause codes are intended to provide data for injury research and evaluation of injury prevention strategies. Place of occurrence codes are secondary codes for use after the other external cause code to identify the location of the patient at the time of injury.

Final Points There are an extensive number of guidelines that coders need to understand before assigning codes from Chapter 20 of ICD-10-CM. Facilities may also establish additional guidelines regarding the assignment of these codes.

Coding Practice Select the code for the following: Fall from ladder, initial encounter

Coding Practice Solution Main term to reference in External Cause index: Fall Modifying term: From, off, out of, ladder Code Assignment: W11.xxxA