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

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

3. 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.

4. 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.

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

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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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.

15. 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.

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

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

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