This document provides guidance on using external cause of injury codes, including: 1. External cause codes describe the circumstances surrounding an injury, including how and where it occurred. 2. There are different types of external cause codes that describe how the injury happened, where it happened, what the patient was doing, and whether the intent was intentional or unintentional. 3. External cause codes are used with injury codes in ranges A00-T88 or Z00-Z99. The 7th character must match between the injury and external cause codes. 4. Examples are provided to demonstrate proper use of external cause codes according to the described guidelines.

1. EXTERNAL CAUSES
OF MORBIDITY

2. INTRODUCTION
O This chapter refers for the cause of an
injury or health conidtion,whether the
intent behind the cause was intentional or
unintentional/accidental(ex;whether an
injury was due to suicide or assault)the
patients location or activity at the time of
the event,and whether the patient was a
civilian or in the military

3. O These codes may also apply to diseases
infections, and other health conditions that
can be attributed to an external cause and
that can be reported with a code in the
range of A00.0-T88.9 or Z00-Z99.
O Example; if a stroke occurs during a
boxing match or a player has a heart
attack during a football game.

4. O It would be appropriate to apply an
external cause code.
O Never assign chapter-20 codes as the
primary codes.

5. Types of external cause codes
four different types of external cause codes
1. How did the injury or condition happen
2. Where did it happen
3. What was the patient doing when it
happens
4. Was it intentional or unintentional

6. Guidelines
O Used with any code in the range of A00.0-
T88.9,Z00-Z99
O The 7th character for external cause
should match the 7th character of the code
assigned for the associated injury or
condition for the encounter
O Use the full range of external cause codes

7. O If only one external code can be recorded
assign the code most related to the
principal diagnosis
O An external cause code can never a
principal code
O Do not use external cause code if the
external cause and intent are included in a
code from another chapter

8. O Codes from category y92 place of
occurrence of the external cause are
secondary codes for use after other
external cause codes to identify the
location of the patient at the time of injury
or other condition
O Place of occurence is used only once
O No 7th characters are used for y92

9. O Do not use place of occurence code y92.9
if the place is not stated or is not
applicable.
O Only one code from activity y93 is
reported for initial encounter.
O Do not assign y93.9 unspecified activity,if
the activity is not stated
O The activity codes are not applicable to
poisonings, adverse effects,
misadvantages,or sequela

10. LIST OF SECTIONS
O V00-V09 Pedestrian injured in transport accident
O V10-V19 Pedal cycle rider injured in transport
accident
O V20-V29 Motorcycle rider injured in transport
accident
O V30-V39 Occupant of three-wheeled motor
vehicle injured in transport accident
O V40-V49 Car occupant injured in transport
accident
O V50-V59 Occupant of pick-up truck or van injured
in transport accident

11. O V60-V69 Occupant of heavy transport vehicle
injured in transport accident
O V70-V79 Bus occupant injured in transport
accident
O V80-V89 Other land transport accidents
O V90-V94 Water transport accidents
O V95-V97 Air and space transport accidents
O V98-V99 Other and unspecified transport
accidents
O W00-W19 Slipping, tripping, stumbling and
falls

12. O W20-W49 Exposure to inanimate mechanical
forces
O W50-W64 Exposure to animate mechanical
forces
O W65-W74 Accidental non-transport drowning
and submersion
O W85-W99 Exposure to electric current,
radiation and extreme ambient air
temperature and pressure
O X00-X08 Exposure to smoke, fire and flames
O X10-X19 Contact with heat and hot
substances

13. O X30-X39 Exposure to forces of nature
O X50-X50 Overexertion and strenuous or
repetitive movements
O X52-X58 Accidental exposure to other
specified factors
O X71-X83 Intentional self-harm
O X92-Y09 Assault
O Y21-Y33 Event of undetermined intent

14. O Y35-Y38 Legal intervention, operations of war,
military operations, and terrorism
O Y62-Y69 Misadventures to patients during
surgical and medical care
O Y70-Y82 Medical devices associated with adverse
incidents in diagnostic and therapeutic use
O Y83-Y84 Surgical and other medical procedures
as the cause of abnormal reaction of the patient, or
of later complication, without mention of
misadventure at the time of the procedure
O Y90-Y99 Supplementary factors related to causes
of morbidity classified elsewhere

15. EXAMPLES
O Ex; 23-year old motor cycle driver collided
with animal on the interstate highway. the
driver confessed to using his cell phone.
O Ans;V20.4XXA,Y92.411,Y93.C2
O Ex; The patient was bitten by while
attempting to rescue it from an abandoned
barn while performing his job at animal
control
O Ans;W55.01XA,Y92.71,Y93.K9,Y99.0

16. O Ex; A cook in restaurant accidentally
burned with running hot tap water while on
duty.assign the ext cause codes
O Ans;X11.1XXA,Y92.511,Y93.G3,Y99.0
O Ex; This is patient established visit for
lumbar vertebra fracture,fall from
ladder.receiving physical therapy, came
for follow-up.
O Ans;s32.019D,W11.XXXD

17. O Ex; pedestrian while running, injured in
collision with pedal cycle in nontraffic
accident, fractured shaft of femur.
O Ans;S72.309B,V01.00XA,Y93.02,Y99.8.
O Ex; Fall on escalator in airport
building,assign the Ext cause codes
O Ans;W10.0XXA,Y92.520

18. O EX; clothing caught fire while burning
household trash in backyard of home.
O Ans;X03.0XXA,X06.2XXA,Y92.096,Y93.E
9,Y99.8
O Ex; passenger injured when he
accidentally collided with another
passenger while getting off street car onto
road
O Ans;V82.4XXA,Y92.410

19. O Code range for motorcycle injuries-V20
O Code range for falls-W00
O https://www.medesunglobal.com

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