A chilling selection of ICD-10-CM external causes codes

So how would you like to explain this accident to your physician? Doctor, I was crossing the street wearing ice skates and was hit by a bicycle.

Believe it or not, there’s an ICD-10-CM code for just such an occasion:

• V06.19, pedestrian with other conveyance injured in collision with other nonmotor vehicle in traffic accident

That code includes a long list of specific circumstances, such as:

• Pedestrian on ice-skates injured in collision with other nonmotor vehicle in traffic accident
• Pedestrian on sled injured in collision with other nonmotor vehicle in traffic accident
• Pedestrian on snowboard injured in collision with other nonmotor vehicle in traffic accident
• Pedestrian on snow-skis injured in collision with other nonmotor vehicle in traffic accident

Odds are, you won’t use code V06.19 often, but it’s there if you need it.

ICD-10-CM contains a wide range of codes for external causes, so let’s look at some of the others you may need during the winter.

New England is bracing for a major snow storm this weekend, so we may see people come in with various injuries caused by activities involving ice and snow (Y93.2). Note that the Y93.2 series excludes injuries related to shoveling ice and snow. They have their own external causes code—Y93.H1.

We’ll also report X37.2 (blizzard [snow][ice]).  Don’t forget the seventh character to denote the encounter.

Perhaps your patient is Lindsey Vonn, the Olympic skier who recently suffered torn knee ligaments in a horrible crash during a race. If we code the activity of skiing, we need to know what type of skiing:

• Y93.23, activity, snow (alpine) (downhill) skiing, snow boarding, sledding, tobogganing, and snowtubing
• Y93.24, activity, cross country skiing

In Lindsey’s case, it’s downhill skiing, so we would code Y93.23 in addition to her injury codes.

What other trouble can we get into in the snow? We could fall because of the snow and ice (it’s not fun, I don’t recommend it). In that case, we would report a code from the W00.- series (fall due to ice and snow):

• W00.0, fall on same level due to ice and snow
• W00.1, fall from stairs and steps due to ice and snow
• W00.2, other fall from one level to another due to ice and snow
• W00.9, unspecified fall due to ice and snow

These codes require a seventh character to denote the encounter, so we’ll need to add two X placeholders so our seventh character ends up in the seventh place.

W00.0 also includes collusions with another person, so when you go sliding across the icy sidewalk straight into an innocent bystander, you get W00.0XXA (for the initial encounter).

If a patient comes in suffering from hypothermia (T68-), we need use additional code to identify source of exposure:

• Exposure to excessive cold of man-made origin (W93)
• Exposure to excessive cold of natural origin (X31)

W93 requires a seventh character to denote the encounter type and includes:

• Excessive cold as the cause of chilblains NOS
• Excessive cold as the cause of immersion foot or hand
• Exposure to cold NOS
• Exposure to weather conditions

W93 specifically excludes:

• cold of man-made origin (W93.-)
• contact with or inhalation of:
• dry ice (W93.-)
• liquefied gas (W93.-)

All of these winter codes are making me cold. Pass the hot chocolate.