INJURY CODES IN ICD-10-CM

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1 INJURY CODES IN ICD-10-CM Training for Trauma Registrars 7/18/14 Holly Hedegaard, MD, MSPH 1

2 TRAINING OVERVIEW General description of ICD-10-CM Chapter 19, Injury Diagnosis Codes Break for Lunch Chapter 20, External Cause of Injury Codes Related codes to consider 2

3 ICD-10-CM Clinical modification of ICD-10 First draft for public comment in 1997 Field tested by the AHA and AHIMA in 2003 New concepts/codes added annually through the ICD Coordination and Maintenance Committee at NCHS 3

4 WHAT S NEW IN ICD-10-CM? Relevant codes for ambulatory and managed care encounters Greater specificity in code assignment Addition of sixth and seventh characters Combination diagnosis/symptom codes Expanded injury codes Of the approx 70,000 codes in ICD-10-CM, 43,000 are in the injury chapters! 4

5 ICD-10-CM ON-LINE 1. Scroll down to FY 2015 release of ICD-10-CM 2. Select ICD-10-CM PDF Format 3. Select ICD10CM_FY2015_Full_PDF.zip 4. Select FY15_Tabular.PDF 5. Select Chapter 19 (injury diagnosis codes) or Chapter 20 (external cause codes) 5

6 GENERAL EQUIVALENCE MAPS (GEMS) A code to code reference dictionary for ICD-9- CM and ICD-10-CM Offers possible acceptable translation alternatives One ICD-9-CM code can be represented by multiple ICD-10-CM codes and vice versa New concepts in ICD-10-CM that have no predecessor in ICD-9-CM (e.g., underdosing, blood type, Glasgow Coma Scale) 6

7 ICD-10-CM GEMS 1. Scroll down to FY 2015 release of ICD-10-CM 2. Select General Equivalence Mapping Files 7

8 CHAPTER 19 INJURY DIAGNOSIS CODES 8

9 SECTION OVERVIEW General differences between ICD-9-CM and ICD-10-CM ICD-10-CM code structure Details for specific body regions 9

10 ICD-9-CM VS ICD-10-CM FOR INJURY DIAGNOSES Approx 2,600 codes Code range Approx 43,000 codes S and T codes 3-5 characters 3-7 characters x placeholder Specificity limited No specifics on laterality Greater specificity Codes for right, left, bilateral 10

11 ICD-9-CM VS ICD-10-CM FOR INJURY DIAGNOSES ICD-9-CM: Fracture of shaft of ulna, closed ICD-10-CM: S52.244A Nondisplaced spiral fracture of shaft of ulna, right arm, initial encounter for closed fracture 11

12 S52.244A Nondisplaced spiral fracture of shaft of ulna, right arm, initial encounter for closed fracture Injury Chapter 12

13 S52.244A Nondisplaced spiral fracture of shaft of ulna, right arm, initial encounter for closed fracture Major Body Region 13

14 S52.244A Nondisplaced spiral fracture of shaft of ulna, right arm, initial encounter for closed fracture Major nature of injury 14

15 S52.244A Nondisplaced spiral fracture of shaft of ulna, right arm, initial encounter for closed fracture Specific details on body region and nature of injury 15

16 S52.244A Nondisplaced spiral fracture of shaft of ulna, right arm, initial encounter for closed fracture Type of Encounter 16

17 CHANGE IN PRIMARY AXIS OF INJURY DIAGNOSIS CODES ICD-9-CM Fractures Dislocations Sprains/Strains ICD-10-CM Injuries to head Injuries to neck Injuries to thorax S00-S09 S10-S19 S20-S29 17

18 STRUCTURE OF INJURY DIAGNOSIS CODES IN ICD-10-CM Head Neck Thorax Injury to: Abdomen, lower back, lumbar spine, pelvis, and external genitals Shoulder and upper arm Elbow and forearm Wrist, hand and fingers Hip and thigh Knee and lower leg Code Range S00-S09 S10-S19 S20-S29 S30-S39 S40-S49 S50-S59 S60-S69 S70-S79 S80-S89 Ankle and foot S90-S99 18

19 STRUCTURE OF INJURY DIAGNOSIS CODES IN ICD-10-CM Type of Injury at 3rd Character (in general) 0 Superficial injury 1 Open wound 2 Fracture 3 Dislocation and sprain 4 Injury of nerves 5 Injury of blood vessels 6 Injury of muscles and tendons 9 Other and unspecified 19

STRUCTURE OF INJURY DIAGNOSIS CODES IN ICD-10-CM S00 Superficial injury of head S10 Superficial injury of neck S20 Superficial injury of thorax S30 Superficial injury of abdomen, lower back, and

20 STRUCTURE OF INJURY DIAGNOSIS CODES IN ICD-10-CM S00 Superficial injury of head S10 Superficial injury of neck S20 Superficial injury of thorax S30 Superficial injury of abdomen, lower back, and pelvis S01 Open wound of head S11 Open wound of neck S21 Open wound of thorax S31 Open wound of abdomen, lower back, and pelvis S02 Fracture of skull and facial bones S12 Fracture of neck S22 Fracture of rib(s), sternum and thoracic spine S32 Fracture of lumbar spine and pelvis 20

21 S52.244A Nondisplaced spiral fracture of shaft of ulna, right arm, initial encounter for closed fracture Specific details on body region and nature of injury 21

22 SUPERFICIAL INJURY (3 RD CHARACTER = 0) Specific type of superficial injury provided in 5th character Abrasion Blister Contusion External constriction Superficial foreign body Insect bite (nonvenomous) 22

23 SUPERFICIAL INJURY (3 RD CHARACTER = 0) S00.211A Abrasion of right eyelid and periocular area, initial encounter S = Injury Chapter 0 = Head 0 = Superficial injury. 2 = Eyelid and periocular area 1 = Abrasion 1 = Laterality (right) A = Initial encounter 23

24 OPEN WOUND (3 RD CHARACTER = 1) Specific type of open wound provided in 5th character Laceration w/foreign body Laceration w/o foreign body Puncture wound w/foreign body Puncture wound w/o foreign body Bite 24

25 OPEN WOUND (3 RD CHARACTER = 1) S41.031A Puncture wound without foreign body of right shoulder, initial encounter S = Injury Chapter 4 = Shoulder and upper arm 1 = Open wound. 0 = Shoulder 3 = Puncture wound w/o foreign body 1 = Laterality (right) A = Initial encounter 25

26 OPEN WOUND (3 RD CHARACTER = 1) Specific type of open wound provided in 5th character S41.01 Laceration of shoulder without foreign body S41.02 Laceration of shoulder with foreign body S41.03 Puncture wound of shoulder without foreign body body 26

27 FRACTURE (3 RD CHARACTER = 2) Specific type of fracture provided in 5th character Comminuted Greenstick Oblique Spiral Segmental Torus Transverse Displaced vs non-displaced 27

28 FRACTURE (3 RD CHARACTER = 2) S Greenstick fx, shaft of left humerus S Spiral fx, shaft of left humerus S Comminuted fx, shaft of left humerus S Segmental fx, shaft of left humeruss 28

29 LATERALITY ( 6 TH CHARACTER ) S Abrasion of right ear S Laceration without foreign body, left knee S22.43 Multiple fractures of ribs, bilateral S Nondisplaced oblique fracture of shaft of unspecified femur 29

30 TYPE OF ENCOUNTER 7 TH CHARACTER A: Initial encounter Active treatment, ER encounter, evaluation and treatment by new physician D: Subsequent encounter Routine care during healing phase (e.g., cast change/removal, removal of external fixation device) S: Sequela Complications or conditions that arise as a direct result of the injury of an injury 30

$TYPE OF ENCOUNTER 7 TH CHARACTER FRACTURES A B D G K P S Initial encounter for closed fracture Initial encounter for open fracture Subsequent encounter for fracture with$

31 TYPE OF ENCOUNTER 7 TH CHARACTER FRACTURES A B D G K P S Initial encounter for closed fracture Initial encounter for open fracture Subsequent encounter for fracture with routine healing Subsequent encounter for fracture with delayed healing Subsequent encounter for fracture with nonunion Subsequent encounter for fracture with malunion Sequelae 31

32 A B C D E F G H J TYPE OF ENCOUNTER S52 FRACTURE OF FOREARM Initial encounter for closed fracture Initial encounter for open fracture type I or II Initial encounter for open fracture type IIIA, IIIB, or IIIC Subsequent encounter for closed fracture with routine healing Subsequent encounter for open fracture type I or II with routine healing Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing Subsequent encounter for closed fracture with delayed healing Subsequent encounter for open fracture type I or II with delayed healing Subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing etc. (7 more categories) 32

33 DETAILS FOR SPECIFIC BODY REGIONS 33

34 HEAD (S00-S09) Unique codes for skull fx and intracranial injury No combo codes as in ICD-9-CM Skull fx codes do not include modifier for loss of consciousness (LOC) No distinction for closed vs open Include 7 th character for type of encounter A = initial encounter for closed fx B = initial encounter for open fx Include codes for any associated open wounds (S01.-) 34

35 HEAD (S00-S09) Specific codes for LeFort fx S LeFort I fracture S LeFort II fracture S LeFort III fracture 35

36 S06 INTRACRANIAL INJURY S06.0 Concussion S06.1 Traumatic cerebral edema S06.2 Diffuse traumatic brain injury S06.3 Focal traumatic brain injury Specific codes for right and left S06.4 Epidural hemorrhage S06.5 Traumatic subdural hemorrhage S06.6 Traumatic subarachnoid hemorrhage S06.8 Other specified intracranial injuries Internal carotid, intracranial portion S06.9 Unspecified intracranial injury 36

37 S06.0X Concussion S06.0X0 S06.0X1 S06.0X2 S06.0X3 S06.0X4 S06.0X5 S06.0X6 S06.0X7 S06.0X8 S06.0X9 S06 INTRACRANIAL INJURY LOC MODIFIER Without LOC LOC 30 mins or less LOC 31 mins to 59 mins LOC 1 hr to 5 hrs 59 mins LOC 6 hrs to 24 hrs LOC>24 hrs w/return to pre-existing conscious level LOC >24 hrs w/o return to pre-existing conscious level with pt surviving LOC of any duration w/death due to TBI prior to regaining consciousness LOC of any duration w/death due to other cause prior to regaining consciousness With LOC of unspecified duration 37

38 NECK (S10-S19) Unique codes for vertebral fracture and spinal cord injury No combo codes as in ICD-9-CM Specific codes for: Vertebral fracture vs spondylolisthesis Dislocation vs subluxation Minor vs major laceration of blood vessels Laterality of blood vessels 38

39 THORAX (S20-S29) Detailed codes for fx of thoracic vertebrae Wedge compression, burst, unstable burst, other, unspecified fx A fx not indicated as displaced vs non-displaced should be coded to displaced Specific codes for: Laterality for rib fx Subluxation vs dislocation of thoracic vertebrae Minor vs major laceration of blood vessels Laterality of blood vessels Unilateral vs bilateral injuries to lungs and bronchi 39

40 ABDOMEN, LOWER BACK, LUMBAR SPINE, PELVIS, ETC. (S30-S39) No distinction between closed vs open injuries to organs Code any associated open wounds (S31.-) Detailed codes for fx of lumbar vertebrae Wedge compression, burst, unstable burst, other, unspecified fx A fx not indicated as displaced vs non-displaced should be coded to displaced 40

41 ABDOMEN, LOWER BACK, LUMBAR SPINE, PELVIS, ETC. (S30-S39) Specific codes for: Open wound of abdomen +/- penetration into peritoneal cavity, by quadrant Minor vs major laceration of blood vessels Injuries to ovary, fallopian tube, prostate Laterality of blood vessels and organs (kidney, ovary) 41

42 ABDOMEN, LOWER BACK, LUMBAR SPINE, PELVIS, ETC. (S30-S39) Sacral fx 2 codes in ICD-9-CM (closed vs open fx) 16 codes in ICD-10-CM (Zone I-III, Type 1-4, nondisplace vs minimally displaced vs severely displaced) Acetabular fx 2 codes in ICD-9-CM (closed vs open fx) 54 codes in ICD-10-CM (displaced vs non-displaced, type of fx, location, laterality) 42

43 INJURIES TO EXTREMITIES (S40-S99) Extensive expansion in the number of codes for all structures (bones, blood vessels, nerves, muscles, tendon, joints, etc.) e.g., Clavicle fx 2 codes in ICD-9-CM (closed vs open fx) 24 codes in ICD-10-CM (non-displaced vs displaced, location, laterality) e.g., Open wound of thumb No specific code in ICD-9-CM 36 codes in ICD-10-CM 43

44 INJURIES TO EXTREMITIES (S40-S99) e.g., Femur fx 2 pages of codes in ICD-9-CM 6 pages of codes in ICD-10-CM e.g., Injury to muscle, fascia, tendon No codes Extensive codes, by location and specific muscle e.g., Unique codes for different types of injuries to each finger and toe 44

45 INJURIES TO EXTREMITIES (S40-S99) Complete coding will require very detailed information on all extremity injuries! 45

46 INJURY, POISONING AND OTHER CONSEQUENCES OF EXTERNAL CAUSES (T07-T88) Effects of foreign body entering through natural orifice (T15-T19) Burns and corrosions (T20-T32) Distinction between thermal and chemical burns T31 and T32 codes for %TBSA burn, corrosion Frostbite (T33-T34) Superficial (T33) vs with tissue necrosis (T34) 46

47 INJURY, POISONING AND OTHER CONSEQUENCES OF EXTERNAL CAUSES (T07-T88) Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50) Toxic effects of substances chiefly nonmedicinal as to source (T51-T65) T63 Toxic effect of contact with venomous animals and plants (snake bites, scorpion stings) 47

48 INJURY, POISONING AND OTHER CONSEQUENCES OF EXTERNAL CAUSES (T07-T88) Other and unspecified effects of external causes (T66-T78) T68 T70 Hypothermia Effects of air pressure and water pressure T70.2 Effects of high altitude T70.4 Effects of high-pressure fluid injection T71 Asphyxiation (40+ codes) T75.0 Effects of lightning T75.1 Unspecified effects of drowning and nonfatal submersion 48

49 INJURY, POISONING AND OTHER CONSEQUENCES OF EXTERNAL CAUSES (T07-T88) Other and unspecified effects of external causes (T66-T78) T74 Adult and child abuse, neglect and other maltreatment, confirmed T76 Adult and child abuse, neglect and other maltreatment, suspected 49

50 QUESTIONS? 50

51 CHAPTER 20 EXTERNAL CAUSE CODES 51

52 SECTION OVERVIEW General differences between ICD-9-CM and ICD-10-CM ICD-10-CM code structure for land transport Details for specific external causes 52

53 ICD-9-CM VS ICD-10-CM FOR EXTERNAL CAUSE Approx 1,300 codes Approx 7,500 E codes V, W, X, and Y codes* 3-5 characters 3-7 characters x placeholder Includes poisoning, FB, asphyxiation/suffocation/ strangulation, etc. Child/adult abuse/maltreatment Moved to T codes in injury diagnosis chapter Included as T codes in injury diagnosis chapter * E codes in ICD-10-CM describe Endocrine, Metabolic and Nutritional disorders! 53

54 ICD-9-CM VS ICD-10-CM FOR EXTERNAL CAUSE ICD-9-CM: E888.0 Fall resulting in striking against sharp object ICD-10-CM: W Fall on same level from slipping, tripping and stumbling with subsequent striking against sharp glass 54

55 ICD-10-CM EXTERNAL CAUSE OF INJURY Transportation Category Slipping, tripping, stumbling & falls Exposure to inanimate mechanical forces Exposure to animate mechanical forces Accidental non-transport drowning and submersion Exposure to electric current, radiation and extreme ambient air temperature and pressure Exposure to smoke, fire and flames Contact with heat and hot substances Exposure to forces of nature Accidental exposure to other specified factors Code Range V00-V99 W00-W19 W20-W49 W50-W64 W65-W74 W85-W99 X00-X08 X10-X19 X30-X39 X52-X58 55

56 ICD-10-CM EXTERNAL CAUSE OF INJURY Intentional self-harm Assault Category Event of undetermined intent Legal intervention, operations of war, military operations, and terrorism Code Range X71-X83 X92-Y08 Y21-Y33 Y35-Y38 56

57 LAND TRANSPORT IN ICD-9-CM Was a motor vehicle involved? Where did the event occur? (public roadway?) Did the event involve a single MV or 2+ MV? What did the MV do? Collide with something? Lose control, rollover? Leave roadway, re-enter and collide with 2 nd MV? Head-on, Rear-end, T-bone, hit parked car? 4 th digit to identify the injured person 57

58 LAND TRANSPORT IN ICD-9-CM Was a motor vehicle involved? Where did the event occur? (PR vs not a PR) Did the event involve a single MV vs 2+ MV? What did the MV do? Collide with something? Lose control, rollover? Leave roadway, re-enter and collide with 2 nd MV? Head-on, Rear-end, T-bone, hit parked car? 4 th digit to identify the injured person 58

59 LAND TRANSPORT IN ICD-10-CM V11.0 Pedal cycle driver injured in collision with other pedal cycle in nontraffic accident 59

60 LAND TRANSPORT IN ICD-10-CM V11.0 Pedal cycle driver injured in collision with other pedal cycle in nontraffic accident Transportation 60

61 LAND TRANSPORT IN ICD-10-CM V11.0 Pedal cycle driver injured in collision with other pedal cycle in nontraffic accident Who was hurt? 61

62 LAND TRANSPORT IN ICD-10-CM V11.0 Pedal cycle driver injured in collision with other pedal cycle in nontraffic accident Collision with? 62

63 LAND TRANSPORT IN ICD-10-CM V11.0 Pedal cycle driver injured in collision with other pedal cycle in nontraffic accident Other details 63

64 LAND TRANSPORT 2 ND CHARACTER Who was injured? Pedestrian Pedal cycle rider Motorcycle rider Occupant of three-wheeled motor vehicle Car occupant Occupant of pick-up truck or van Occupant of heavy transport vehicle Bus occupant Code Range V00-V09 V10-V19 V20-V29 V30-V39 V40-V49 V50-V59 V60-V69 V70-V79 64

65 LAND TRANSPORT 3RD CHARACTER Collision with? Code Pedestrian or animal 0 Pedal cycle 1 Two- or three-wheeled motor vehicle 2 Car, pick-up truck, van 3 Heavy transport vehicle or bus 4 Railway train or railway vehicle 5 Non-motor vehicle 6 Fixed or stationary object 7 Non-collision 8 Other and unspecified motor vehicles 9 65

66 Other details: LAND TRANSPORT 4 TH AND 5 TH CHARACTERS Driver, passenger, person on outside of vehicle, unspecified Boarding or alighting Traffic vs non-traffic Specific vehicle types: military vehicle, SUV 66

67 PEDESTRIAN Includes: Person changing tire on transport vehicle Person examining engine of vehicle broken down in (on side of) road Excludes: Fall due to non-transport collision with other person (W03) Pedestrian on foot falling (slipping) on ice and snow (W00.-) Struck or bumped by another person (W51) 67

68 PEDESTRIAN (CONVEYANCE) Types of pedestrian conveyance Rolling type: Roller skates (in-line and non-inline), skateboard, non-motorized scooter, heelies, other Gliding type: Ice skates, sled, other Flat bottomed: Snowboard, snowskis, other Other: wheelchair (including powered), baby stroller, motorized mobility scooter, other 68

69 PEDESTRIAN (CONVEYANCE) Excludes: Collision with another person without fall (W51) Fall due to person on foot colliding with another person on foot (W03) Fall from non-moving wheelchair, nonmotorized scooter and motorized mobility scooter without collision(w05.-) Pedestrian on foot falling (slipping) on ice and snow (W00.-) 69

70 CONSIDERATIONS FOR LAND TRANSPORT ACCIDENTS A transport accident is one in which the vehicle involved must be moving or running or in use for transport purposes at the time of the accident. Use additional codes to identify: Airbag injury W22.1 Type of street or road Y92.4- Use of cell phone and other electronic equipment at time of crash Y93.C- 70

71 OTHER LAND TRANSPORT ACCIDENTS (V80-V89) Who was injured? Animal-rider or occupant of animal-drawn vehicle Occupant of railway train or railway vehicle Occupant of powered streetcar Occupant of special vehicle mainly used on industrial premises Occupant of special vehicle mainly used in agriculture Occupant of special construction vehicle Occupant of special all-terrain or other off-road motor vehicle* Code Range V80 V81 V82 V83 V84 V85 V86 *Includes ambulance, fire engine, snowmobile, dune buggy, military vehicle, golf cart, go-cart, dirt bike, etc. 71

72 LAND TRANSPORT (V00-V89) 51 pages of Land Transportation codes! 72

73 WATER TRANSPORT ACCIDENTS (V90-94) Drowning and submersion due to accident to watercraft Other injury* due to accident to watercraft Drowning and submersion due to accident on board watercraft, without accident to watercraft Other injury* due to accident on board watercraft, without accident to watercraft Other and unspecified water transport accidents Code Range V90 V91 V92 V93 V94 *Includes burn, crush, fall, hit or struck by falling object, other 73

74 WATER TRANSPORT ACCIDENTS Types of events Watercraft overturning Watercraft sinking Falling or jumping from burning watercraft Falling or jumping from crushed watercraft Collision between watercraft and other watercraft or object Hit or struck by falling object due to accident to watercraft Thrown overboard by motion of watercraft Burned by localized fire on watercraft Heat exposure on watercraft Explosion on watercraft Machinery accident on watercraft AND MORE! (V90-94) 74

75 WATER TRANSPORT ACCIDENTS (V90-94) Types of watercraft Merchant ship Passenger ship: Ferryboat, Ocean Liner Fishing boat Other powered watercraft: Hovercraft, Jet-ski Sailboat Canoe or kayak Non-powered inflatable craft Unpowered watercraft: Surfboard, Windsurfer Water-skis 75

76 SLIPPING, TRIPPING, STUMBLING AND FALLS (W00-W19) New concepts: W00 W04 W16 Fall due to ice and snow Fall while being carried or supported by other person Falling, jumping or diving into water W17.82 Fall from (out of) grocery cart 76

77 EXPOSURE TO INANIMATE MECHANICAL FORCES (W20-W49) Struck by/against object Caught/crushed between objects Contact with lifting and transmission devices Contact with sharp objects Contact with tools/machinery Firearms Explosions Code Range W20-W22 W23 W24 W25-W26 W27-W31 W32-W34 W35-W40 Exposure to other inanimate mechanical forces W42, W45, W46, W49 77

78 EXPOSURE TO INANIMATE MECHANICAL FORCES (W20-W49) New concepts: W21 Striking against or struck by sports equipment (codes for specific items) W22.1 Striking against or struck by automobile airbag W29.4 Contact with nail gun 78

79 EXPOSURE TO ANIMATE MECHANICAL FORCES (W50-W64) Includes accidentally struck by other person W50 W51 W52 Accidental hit, strike, kick, twist, bite or scratch by another person Accidental striking against or bumped into by another person Crushed, pushed or stepped on by crowd or human stampede Includes injuries from contact with animals Cow, pig, raccoon, dolphin, sea lion, orca, shark, crocodile, alligator, turtle, parrot, macaw, psittacines, chicken, turkey, goose, duck, frogs AND MORE! 79

80 OTHER EXTERNAL CAUSES Similar to ICD-9-CM but with more detail available Remember that some external causes are now captured in T-codes 80

GENERAL PRINCIPLES FOR ASSIGNING EXTERNAL CAUSE Codes for child and adult abuse Codes for terrorism events Codes for cataclysmic events Codes for transport accident All other external causes

81 GENERAL PRINCIPLES FOR ASSIGNING EXTERNAL CAUSE Codes for child and adult abuse Codes for terrorism events Codes for cataclysmic events Codes for transport accident All other external causes The first-listed external cause code should correspond to the cause of the most serious diagnosis due to an assault, accident, or self-harm, following the order of hierarchy listed above. 81

82 QUESTIONS? 82

83 OTHER CONSIDERATIONS 83

84 PLACE OF OCCURRENCE (Y92) Code Range Non-institutional (private) residence Y92.0 Institutional (nonprivate) residence Y92.1 School, other institution and public administrative area Y92.2 Sports and athletics area Y92.3 Street, highway and other paved roadways Y92.4 Trade and service area Y92.5 Industrial and construction area Y92.6 Farm Y92.7 Other places Y92.8 Unspecified place Y

85 ACTIVITY (Y93) Indicates the activity the person was engaged in when the injury occurred* Code Range Walking and running Y93.0 Water and water craft Y93.1 Ice and snow Y93.2 Climbing, rappeling and jumping off Y93.3 Dancing and other rhythmic movement Y93.4 Other sports and athletics played individually Y93.5 Other sports and athletics played as a team or group Y93.6 Other specified sports and athletics Y93.7 *Activity contributed to the injury event 85

86 ACTIVITY (Y93) Other cardiorespiratory exercise Other muscle strengthening exercise Computer technology and other electronic devices Arts and crafts Personal hygiene, maintenance of interior property/clothing Care giving Food preparation, cooking and grilling Exterior property and land maintenance, building and construction Roller coasters and other types of external motion Playing musical instrument Animal care Code Range Y93.A Y93.B Y93.C Y93.D Y93.E Y93.F Y93.G Y93.H Y93.I Y93.J 86 Y93.K

87 STATUS (Y99) Indicates the work status of the person at the time the event occurred Y99.0 Civilian activity done for income or pay Y99.1 Military activity Y99.2 Volunteer activity Y99.3 Other external cause status 87

88 OTHER CONSIDERATIONS How complete is the documentation in the medical record? What level of detail in coding is really needed? For your trauma service? For the state trauma registry? Requirements of ACS and NTDB 88

89 OTHER CONSIDERATIONS ICD-10-CM map to AIS NHTSA Request for Information /12/ /icd-10-cmais-mapping-software Comment period ends 8/11/14 89

90 FOR MORE INFORMATION Holly Hedegaard, MD, MSPH National Center for Health Statistics Office of Analysis and Epidemiology

injury poisoning and certain other (s00-t98)

1 of 13 1 injury poisoning and certain other consequences of external causes (s00-t98) ICD S T P10-P15 ( ) O70-O71 ( ) S T injuries to the head (s00-s09) injuries to the neck (s10-s19) injuries to the