In ICD-10-CM, injuries are grouped by body part rather than by category, so all injuries of a specific site (such as head and neck) are grouped together rather than groupings of all fractures or all open wounds.
The External Cause of Injuries index contains codes found in Chapter 19, Injury, poisoning & certain other consequences of external causes , and Chapter 20, External causes of morbidity, of the ICD-10-CM. The codes begin with the letters S and T for Chapter 10, and V, W, X, and Y in Chapter 20.
Categories grouped by injury in ICD-9-CM such as fractures (800–829), dislocations (830–839), and sprains and strains (840–848) are grouped in ICD-10-CM by site, such as injuries to the head (S00–S09), injuries to the neck (S10–S19), and injuries to the thorax (S20–S29).
For aftercare of an injury, coders should assign the acute injury code with the appropriate seventh character "D" (or expanded choices for fractures) for subsequent encounter. This change will be significant for those post-acute settings that provide subsequent care for injuries.
How ICD-10 codes are structuredFirst three characters: General category,Fourth character (to the right of the decimal): The type of injury,Fifth character: Which finger was injured,Sixth character: Which hand was injured,Seventh character: The type of encounter (A, D, or S) as discussed above.
Z02.1Z02. 1 - Encounter for pre-employment examination | ICD-10-CM.
ICD-10 code Y92 for Place of occurrence of the external cause is a medical classification as listed by WHO under the range - External causes of morbidity .
Z02.11.
If you perform a comprehensive physical, choose a procedure code from the Preventive Medicine codes CPT 99381-99387 for a new patient, or CPT 99391-99397 for an established patient, and select the code based on the patient's age.
Z00.00The adult annual exam codes are as follows: Z00. 00, Encounter for general adult medical examination without abnormal findings, Z00.
W01.0XXAICD-10-CM Code for Fall on same level from slipping, tripping and stumbling without subsequent striking against object, initial encounter W01. 0XXA.
ICD-10-CM Code for Single-family non-institutional (private) house as the place of occurrence of the external cause Y92. 01.
Encounter for full-term uncomplicated deliveryICD-10 code O80 for Encounter for full-term uncomplicated delivery is a medical classification as listed by WHO under the range - Pregnancy, childbirth and the puerperium .
In general, the exam includes checking a candidate's vital signs, weight, temperature, pulse, and blood pressure. It may also include specific tests such as drug and alcohol testing, physical ability and stamina testing, and psychological testing.
➢ Z codes indicate the reason for the encounter.
Code R53. 83 is the diagnosis code used for Other Fatigue. It is a condition marked by drowsiness and an unusual lack of energy and mental alertness.
In ICD-10-CM, injuries are grouped by body part rather than by category, so all injuries of a specific site (such as head and neck) are grouped together rather than groupings of all fractures or all open wounds. Categories grouped by injury in ICD-9-CM such as fractures (800–829), dislocations (830–839), and sprains and strains (840–848) are grouped in ICD-10-CM by site, such as injuries to the head (S00–S09), injuries to the neck (S10–S19), and injuries to the thorax (S20–S29).
When coding a poisoning or reaction to the improper use of a medication (e.g., overdose, wrong substance given or taken in error, wrong route of administration), assign first the appropriate code from categories T36–T50. The sequencing for a toxic effect of substances chiefly nonmedicinal as to source (T51-T65) is the same as for coding poisonings. Poisoning codes have an associated intent: accidental, intentional self-harm, assault, and undetermined. Use additional code (s) for all manifestations of poisonings.
Sequela (S) is used for complications or conditions that arise as a direct result of an injury, such as scar formation after a burn. The scars are sequela of the burn. When using seventh character S, it is necessary to use both the injury code that precipitated the sequela and the code for the sequela itself. The S is added only to the injury code, not the sequela code.
The S seventh character identifies the injury responsible for the sequela. The specific type of sequela (e.g., scar) is sequenced first, followed by the injury code. Sequela is the new terminology in ICD-10-CM for late effects in ICD-9-CM and using the sequela seventh character replaces the late effects categories (905–909) in ICD-9-CM.
For complication codes, active treatment refers to treatment for the condition described by the code, even though it may be related to an earlier precipitating problem. For example, code T84.50XA, Infection and inflammatory reaction due to unspecified internal joint prosthesis, initial encounter, is used when active treatment is provided for the infection, even though the condition relates to the prosthetic device, implant or graft that was placed at a previous encounter.
The following coding guidance is provided at the beginning of the chapter, "Use secondary code (s) from chapter 20, External Causes of Morbidity, to indicate cause of injury." Codes within the T section that include the external cause do not require an additional external cause code. The Official Coding Guidelines clarified the use of external cause codes in 2014. The guidelines state: “There is no national requirement for mandatory ICD-10-CM external cause code reporting. Unless a provider is subject to a state-based external cause code reporting mandate or these codes are required by a particular payer, reporting of ICD-10-CM codes in Chapter 20, External Causes of Morbidity, is not required. In the absence of a mandatory reporting requirement, providers are encouraged to voluntarily report external cause codes, as they provide valuable data for injury research and evaluation of injury prevention strategies.”
ICD-10-CM provides greater specificity in coding injuries than ICD-9-CM. While many of the coding guidelines for injuries remain the same as ICD-9-CM, ICD-10-CM does include some new features, such as seventh characters.
The work- related ICD-10- CM codes identified in this study allow for enhanced surveillance of occupational injuries not captured using only WC as the expected payer. As hospitals and healthcare facilities adopted ICD coding for discharge purposes and not injury surveillance purposes, work- related injuries can be better identified using the combined expected payer and external cause code approach based on the results of this study. The unique structure of ICD-10- CM permits the addition of more external cause codes in the future to enhance identification of work- related injuries in population- based discharge datasets.
Injury- related ED visits were identified from records with a discharge date of 1 January 2016, to 31 December 2019, guided by CDC’s 2017 proposed surveillance case definition for injury ED visits.18 Only initial encounters were included (a seventh character of ‘A’ or missing) in the ED dataset using a diagnosis code of S00–S99, T07–T34, T36–T50 with a sixth character of
Ethics approval This study is part of the broad spectrum of the Kentucky Occupational Safety and Health Surveillance program and is approved by the University of Kentucky Institutional Review Board.
Two components are described in the external cause of injury: 1) the vector that transfers energy to the body (for example, fall, motor vehicle traffic accident, burns, poisoning), and 2) the intent of the injury (that is, whether the injury was inflicted purposefully and by whom [self or another person]). For deaths, the intent is also sometimes referred to as the “manner of death.”
The ICD injury matrices are frameworks designed to organize ICD coded injury data into meaningful groupings. The matrices were developed to facilitate national and international comparability in the presentation of injury statistics.
Why are there so many matrices? Injuries can be described in the ICD in two ways; either (1) as “external cause” which describes the cause and intent in a single code or (2) as the “nature of injury” which describes the body and nature of injury in a single code. There are multiple revisions of the ICD.
The external cause of injury describes the vector that transfers the energy to the body (e.g. fall, motor vehicle traffic accident, or poisoning) and the intent of the injury (e.g. whether the injury was inflicted purposefully).
There are multiple revisions of the ICD. There are also clinical modifications which are more detailed for use with morbidity data. There is also a mapping between the revisions of the ICD.
The inclusion of ICD-10-CM non-external cause of morbidity codes Z04.2 (encounter for examination and observation following work accident) and Z57 (occupational exposure to risk factors) warrant further consideration; this study assessed external cause of morbidity codes only. Utilisation of Z codes may provide the reasoning for seeking ED treatment. Examination of Z codes allowed for the identification of possible work-related injury ED visits that would not have been identified by WC expected payer or a work-related external cause code. Specifically, 30% of the 91 visits with a Z04.2 code and 22% of the 176 visits with a Z57 code were not identified by WC expected payer or a work-related code.
11 The first ICD-10-CM overexertion code (X50) went into effect in late 2016, with additional ICD-10-CM overexertion codes (X50.0, X50.1, X50.3 and X50.9) being added in 2019. 11 As a result, actual overexertion injury-related ED visits were quantified by other injury mechanisms, resulting in undercounting.
Assessing work-related injuries through the use of the primary WC payer field alone suggests an undercount of work-related ED visits. 24 This study utilised all three available expected payer fields to identify work-related injuries and examined expected payer using a WC ‘any mention’ approach to expand accurate identification of work-related injury ED visits. The any mention of WC approach allowed 2% more work-related injuries to be identified. Follow-up studies on actual payment are needed.