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.

  1. Never used as a primary diagnosis
  2. Consider how the accident happened
  3. Consider where the accident occurred
  4. Consider what activity was the patient engaged in when the accident happened
  5. 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.


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