ICD-10-CM: Are You Ready for External Cause Coding?
When was the last time you had to code a record where the patient was either pecked by a rooster or injured while tap dancing at a fundraising event?
More than likely, we will all have to brush up on our external cause coding as a result of ICD-10-CM. Since ICD-10-CM is an alphanumeric system, we believe that carriers will want this data submitted when appropriate on injury claims. In ICD-10-CM a separate chapter is dedicated to external cause coding. You will find these codes in Chapter 20, External Causes of Morbidity, with a code range of V00-Y99.
Let’s review the ICD-10-CM rules for proper external cause coding.
- Never used as a primary diagnosis
- Consider how the accident happened
- Consider where the accident occurred
- Consider what activity was the patient engaged in when the accident happened
- External cause code status: indicate whether the accident or injury happened during a paid or volunteer activity (Y99.0-Y99.99)
Here is an example of an accident case coded with ICD-10-CM.
A 30-year-old patient was at a sports gymnasium, participating in a tap dancing contest to raise funds for muscular dystrophy. She slipped on the gym floor and fell, injuring her left ankle. The ankle was X-rayed and no fracture was evident. Her ankle was wrapped in an ACE™ bandage and she was given proper RICE instructions. She will followup with her primary care physician in 3 days. Final diagnosis was a left ankle sprain.
Sprain, left ankle: S93.402A
Slip, fall (same level): W01.0XXA
Place: Sports, gym Y92.39
Activity: Dancing Y93.41
Status: Volunteer Activity Y99.2
Learning something new is always challenging and coding external causes will be no exception. However, with a little practice and careful review of the guidelines you’ll soon develop the confidence to accurate code any injury case in ICD-10-CM.