Know Your Way Around Coding Transport Accidents
Hint: look for details about the type of vehicle involved in the accident in the patient’s medical record. The V00.- (Pedestrian conveyance accident) to V99.- (Unspecified transport accident) range of 10th edition of the ICD-10-CM code set covers transport accidents. At first glance, the range appears easily navigable with its divisions based on vehicle type. For a patient injured in a boating accident, reference the V90.- to V94.- (Water transport accidents) code set. When a person operating a vehicle injures a pedestrian in an accident, use the V00.- to V09.- (Pedestrian injured in transport accident) range. Sounds simple enough, right? In reality, the volume of options within the V00.- to V99.- code set runs deep, and it requires coders to know specific details about the patient’s accident and related injury in order to select the correct code. Read on to enhance your coding skills for transport accidents with these tips for navigating the V00.- to V99.- code set. Understand the Basic Structure of V00.-V99 To select the correct code from the V00.- to V99.- range, start with the type of vehicle involved in the accident. Here’s a set of codes arranged by vehicle involved: Next, refer to the details of the incident in the patient’s medical records to determine the most applicable code range within the vehicle type. For example, let’s say the patient has an injury from a bicycle accident. Within the V10.- to V19.- range, there are 10 codes to choose from based on the type of collision. In this example, let’s say the patient collided with a pickup truck. Therefore, the correct code set is V13.- (Pedal cycle rider injured in collision with car, pick-up truck or van). From there, select the code set that best applies to the accident based on whether the incident took place in a non-traffic or traffic setting and whether the patient was a passenger or driving the bicycle. For the purposes of this example, let’s say the patient was the driver in a traffic accident, so the best applicable code set is V13.4- (Pedal cycle driver injured in collision with car, pick-up truck or van in traffic accident). Finally, select the code that makes the most sense based on whether this is the patient’s initial encounter. In this example, assuming that it is the patient’s first encounter, use V13.4XXA (Pedal cycle driver injured in collision with car, pick-up truck or van in traffic accident, initial encounter). In this example, there were ample details in the patient’s record to allow a coder to drill down to the highest level of specificity. In reality, there may not be enough details in the patient’s record to support code selections all the way down to this level. That is why the V00.-V99.- range includes an “unspecified” option at every level. While it’s best practice to specify the exact vehicle type and accident details to determine the most specific possible code, coders have the option to choose “unspecified” if lack of detail in the patient’s medical record prevents a more specific selection. For example, if a patient has an injury from a motorcycle collision with a stationary object, you know to refer to V27.- (Motorcycle rider injured in collision with fixed or stationary object). But if you do not know whether the patient was the driver or a passenger, you would resort to V27.9- (Unspecified motorcycle rider injured in collision with fixed or stationary object in traffic accident) instead of a more specific range. Reference These Tips for Coding Vehicular Accidents Keep in mind that codes in the V00.- to V99.- set may have Excludes1 notes. This is common for collisions that involve military vehicles. For example, V34.4XXA (Person boarding or alighting a three-wheeled motor vehicle injured in collision with heavy transport vehicle or bus, initial encounter) has an Excludes1 note that indicates if the occupant of the three-wheeled motor vehicle sustained their injury in a collision with a military vehicle, the correct code is V39.81XA (Occupant (driver) (passenger) of three-wheeled motor vehicle injured in transport accident with military vehicle, initial encounter). Coders should also keep an eye out for Excludes2 notes in this code set; for example, when working with V93.0- (Burn due to localized fire on board watercraft), note that it excludes the V92.- (Drowning and submersion due to accident on board watercraft, without accident to watercraft) set. If such a situation applies to a patient’s accident, add the appropriate code from V92.- Michelle Falci, BA, M Falci Communications LLC
