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Car Accident, patient went through windshield

  1. #1
    Default Car Accident, patient went through windshield
    Medical Coding Books
    Hello all today at work I had a claim for a patient that was in a car accident, and went through the windshield.

    This had me thinking what external cause code to use for this.

    My thoughts were:

    W22.8XXA - Striking against other object, initial encounter.

    W25.XXXA - Contact with sharp glass, initial encounter.

    W20.8XXA - Other strike by thrown, projected, or falling object, initial encounter.

    I am not sure which to use, because the glass isn't sharp until it was broken. Also the windshield isn't being thrown, projected, or falling on this person. So the only other option I see is, W22.8XXA. Also the claim of course, did not specify if this patient was the driver, or passenger. Also didn't specify if this was in traffic or not, and weather or not this involved other vehicles or just a stationary object. But still these are the only thing I could think of for the windshield part. Is there anything else that may fit?

  2. #2
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    You would code the car collision not the striking he windshield. So you need to know the type of vehicle, and what they struck and whether the patient was passenger or driver.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
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    Yes I know, I used the most generic code for the accident. I do not have my coding books with me so I don't remember the code off the top of my head. But it is one where it describes, motor vehicle accident, (driver or passenger), unspecified. Something like that. I hate using unspecified codes, but I feel like in this case the providers will not know all the information needed. As the patient, went to the hospital first. Then came to us (an FQHC) for prescription refills of pain medicine, like 3 days later. And from what I remember you can use the external cause codes through out care of the patient, until their issues are resolved. If I am incorrect on that point please let me know. But also, you wouldn't use any other codes to describe the motor vehicle accident? Only the code for the motor vehicle accident?

  4. #4
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    V00-V09 range is for pedestrian in transport accident.


    V03.- range is for pedestrian hit by car, pickup truck or van
    CPC-P-A (11/2016), COC-A (9/2016), CPC-A (11/2015), PAHM (2010)
    Fee Schedule Configuration Specialist - Remote

    15 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

  5. #5
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    Well I am pretty certain they were a driver or passenger, not a pedestrian. I am basically just asking about the windshield part. If that should be coded for or not. Because the other response seems to just indicate that coding for the motor vehicle accident is all that is needed. But thanks for the reply.

  6. #6
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    Sorry, i misread somehow. If you weren't the initial place of treatment, I don't believe you need to be as detailed. The fact the patient was in a car accident is sufficient.

    Also note external cause codes are not mandatory. According to the ICD-10-CM guidelines.

    There is no national requirement for mandatory ICD-10-CM external causecode reporting. Unless a provider is subject to a state-based external causecode reporting mandate or these codes are required by a particular payer,reporting of ICD-10-CM codes in Chapter 20, External Causes of Morbidity, isnot required. In the absence of a mandatory reporting requirement, providersare encouraged to voluntarily report external cause codes, as they providevaluable data for injury research and evaluation of injury prevention strategies
    CPC-P-A (11/2016), COC-A (9/2016), CPC-A (11/2015), PAHM (2010)
    Fee Schedule Configuration Specialist - Remote

    15 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

  7. #7
    Default
    Wow thank you, that is extremely good to know. I'm guessing that comes from the guide lines for the external cause codes chapter in the ICD-10 book?

  8. #8
    Default
    Sorry I usually put the guideline section info. Its from I.C.20 paragraph 3
    CPC-P-A (11/2016), COC-A (9/2016), CPC-A (11/2015), PAHM (2010)
    Fee Schedule Configuration Specialist - Remote

    15 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

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