'Tis the Season: ICD-10 Holiday Coding Guide

The holiday season is upon us — a time to deck the halls, indulge in tasty treats, and gather with loved ones. With all the hustle and bustle of this time of year, it’s no surprise that all the season’s festive activities bring with them the risk of accidents, injuries, and illnesses.
As everyone celebrates the holidays, emergency rooms, urgent care centers, and family practices gear up to deal with festivity-related mishaps. Document these mishaps with the help of this holiday coding guide, which lists various conditions your physicians may diagnosis this time of year, and the corresponding ICD-10-CM codes.

Beware Winter Weather

W00.9xxA  Unspecified fall due to ice and snow, initial encounter

Running around in the snow and ice often results in weather-related accidents. Additional codes for reporting falls due to snow and ice include W00.0 Fall on the same level due to ice and snow and W00.1 Fall from stairs and steps due to the ice and snow. Make sure you include the appropriate seventh character to indicate the encounter.

Y93.23  Activity, snow skiing, snowboarding, sledding, tobogganing, and snow tubing

Those dreaming of a white Christmas, wanting to get out and enjoy the white powder this holiday season, might decide to go skiing, snow tubing, or sledding. As fun as these activities are, they can also prove dangerous and result in injuries. Other codes for activity-related injuries include Y93.24 Activity, cross country skiing, V00.2115 Fall from ice skates, and V98.3 Accident involving a ski lift.

And for those snowball fight enthusiasts who stayed out in the cold too long, they might end up with T33.5 Superficial frostbite of wrist and hand or T.34.5 Frostbite with tissue necrosis of wrist and hand.
Use these codes when grandma, or anyone else for that matter, gets run over by a reindeer coming home from your house Christmas Eve.

• V06.00xA  Pedestrian on foot injured in collision with other nonmotor vehicle in nontraffic accident, initial encounter
• W55.32xA Struck by other hoof stock, initial encounter

And if a jolly older gentleman is seeking medical attention around Dec. 24, consider using either:

• V80.929A Occupant of animal-drawn vehicle injured in unspecified transport accident, initial encounter, or
• V80.1  Animal-rider or occupant of animal-drawn vehicle injured in collision with pedestrian or animal.

Deck the Halls

Those beautiful displays of lights take plenty of work and entail a good amount of time spent on a ladder. These codes come in handy for reporting when a patient falls while decorating:

• W14 Fall from tree
• W11.xxxA Fall on and from ladder, initial encounter

Holiday Feast Mishaps

W61.43  Pecked by a turkey

Turkeys tend to be a bit on edge around the holiday season. For patients out trying to bring home a live turkey for dinner, getting pecked by a turkey is a potential hazard. Don’t forget to indicate whether it is an initial encounter, sequela, or a subsequent encounter. In cases where the bird only manages to scratch a patient, report W61.49 Other contact with a turkey along with designated specificity.

Y93.G1  Activity, food preparation and clean up

The kitchen can be a dangerous place, between the hot oils and fats, sharp knives, and boiling water. Beware of a crowded kitchen, and make sure to clean up any spills that could pose a fall risk.

The Season for Giving

W52  Crushed, pushed or stepped on by crowd or human stampede

For those brave individuals who head out to the stores to do their Black Friday shopping, there’s always a risk of getting pushed or stepped on as everyone rushes to grab those doorbuster deals before they’re gone. Since this is a category code, you’ll need to include specificity and additional codes for injury to ensure proper reimbursement. When the mall is where your patient got hurt, report Y92.59 Injury at a shopping mall.

Z72.820  Sleep deprivation

Parents may experience sleep deprivation staying up late to wrap last-minute gifts and getting up early to get that holiday dinner done. Kids staying up late in anticipation of the big day are at risk of this, too. When patients don’t get enough shut-eye during the holidays, it can wear them out, which is reported using T73.3xxA Exhaustion due to excessive exertion, initial encounter.

Peace on Earth

Z62.891  Sibling rivalry

While the holidays are all about bringing families together, it doesn’t always go smoothly. Z codes are used to designate reasons for encounters; use Z62.891 when siblings start to squabble over a toy. Report F43.8 Emotional stress to code when tensions are running high and Z63.1 Problems in relationship with in-laws if a family argument gets out of hand.

Other common Christmas-related codes include:

• Z01.00  Encounter for examination of eyes and vision with abnormal findings – for the tiny tots with their eyes all aglow.
• W34.110  Accidental BB gun discharge and malfunction – hoping for an official Red Ryder carbine-action, 200-shot, range model air rifle? Better watch out! “You’ll shoot your eye out.”
• F10.929  Alcohol use, unspecified with Intoxication, unspecified – for those who drank a little too much eggnog
• R12  Heartburn – for patients who consumed too many fatty treats and alcoholic beverages
• R63.2  Polyphagia – for those whose eyes were bigger than their stomachs
• X08.8  Burn by candle – increasingly likely as the nights of Hanukkah progress
• T75.4  Electrocution – when your patient receives an electric shock from stringing up lights that have bare wiring

Find and choose the appropriate ICD-10-CM codes in a flash using our coding tool, AAPC Coder. Happy Holidays!

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Stacy Chaplain

Stacy Chaplain, MD, CPC, is a development editor at AAPC. She has worked in medicine for more than 20 years, with an emphasis on education, writing, and editing since 2015. Chaplain received her Bachelor of Arts in biology from the University of Texas at Austin and her doctorate in medicine from the University of Texas Medical Branch in Galveston. She is a member of the Beaverton, Ore., local chapter.

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