Part B Insider (Multispecialty) Coding Alert

Question: After looking through the external cause codes in the ICD-10 manual, I was a little confused. How should our practice sequence these codes?

Codify Subscriber

Answer: You should use external cause codes as secondary codes to provide additional information. You should never sequence an external cause code as the first-listed or principal diagnosis, according to the ICD-10 Official Guidelines for Coding and Reporting.

External cause codes can tell you the following helpful information:

• Cause: Explains how the injury or health condition happened. For example: A horse struck the patient and injured the patient’s foot — W55.12XA (Struck by horse, initial encounter).
• Intent: Explains whether the injury or health condition was unintentional, accidental, or intentional. For example: The patient intentionally jumped in front of a vehicle and injured his ankle — X81.0XXA (Intentional self-harm by jumping or lying in front of motor vehicle, initial encounter).
• Place: Explains the place where the event occurred. For example: The patient broke her ankle while playing soccer on a soccer field — Y92.322 (Soccer field as the place of occurrence of the external cause).
• Activity: Explains the activity of the patient at the time of the event. For example: The patient was boogie boarding when he broke his toe — Y93.18 (Activity, surfing, windsurfing and boogie boarding).
• Status: Explains the patient’s status. For example: Y99.8 (Other external cause status).

---