# Coding W06



## lfhammons (May 7, 2015)

I am coding a patient's fall from her bed - initial encounter. Fall from bed is W06; however, it requires coding to the 7th digit. I just want to make sure the correct code would be W06.XXXA.


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## mitchellde (May 7, 2015)

lfhammons said:


> I am coding a patient's fall from her bed - initial encounter. Fall from bed is W06; however, it requires coding to the 7th digit. I just want to make sure the correct code would be W06.XXXA.



Yes that is correct.  Most code books use a symbol to the side indicating placeholder x.  The code book I use actually shows all the placeholders in the code so you immediately know to use 1 or 2 or 3.  It is from Channel Publishing.


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## BenCrocker (May 7, 2015)

Just one question, did the patient have a history of falling if yes then if you read the Excludes 2 note at the top of the Falling section you should use Z91.81 as well. Only if there's a history or risk of falling.


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## lfhammons (May 7, 2015)

History or risk of falling is unknown, but the patient does have a dementia diagnosis. I was going to code the fall (W06.XXXA plus the dementia diagnosis (F03.90) since the current ICD-9 dementia diagnosis is 290.0 (senile dementia uncomplicated). This does bring up the question, would the dementia diagnosis be enough to include the Z91.81 diagnosis or would the history of / risk of falls need to be noted?


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## lfhammons (May 7, 2015)

Thanks so much for the info on the code book by Channel Publishing - I am going to look into that.


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## mitchellde (May 7, 2015)

You know the W09.xxxA must be secondary only, if there were any injuries the code those first or if no injuries were found the use code Z04.3 for examination following other accident as the first listed code followed by the dementia code followed by the W09 code.


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## ABridgman (May 8, 2015)

lfhammons said:


> I am coding a patient's fall from her bed - initial encounter. Fall from bed is W06; however, it requires coding to the 7th digit. I just want to make sure the correct code would be W06.XXXA.




As long as you are coding for "initial encounter" yes, that is correct.  If you are coding for a subsequnt encounter for the same thing, the "A" will change to an "S"

Incidentally, W-codes are in the "External Causes Of Morbidity" codes, and cannot be used as the Primary diagnosis....these are the same type of codes that begin with "E" or "V" in ICD-9...and the same coding rules apply to them.


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## BenCrocker (May 8, 2015)

Found in Section 1, C, 20, a, 6


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## mitchellde (May 8, 2015)

ABridgman said:


> As long as you are coding for "initial encounter" yes, that is correct.  If you are coding for a subsequnt encounter for the same thing, the "A" will change to an "S"
> 
> Incidentally, W-codes are in the "External Causes Of Morbidity" codes, and cannot be used as the Primary diagnosis....these are the same type of codes that begin with "E" or "V" in ICD-9...and the same coding rules apply to them.



Subsequent encounter the A changes to a D and if the patient has residuals from the fall then the residual condition is coded , followed by the original injury with an S followed by the external cause (in this case the W09) with an S.  Also the external causes in ICD-10 CM are all of the V, W, X, Y codes and are equivalent to the ICD-9 CM E codes not the V codes, those are not external causes in ICD-9 CM, the equivalent to V will be the ICD-10 CM Z codes which factors that influence health


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