Coding Notes
Coding for External Causes of
Morbidity in ICD-10-CM
By Karen Kostick, RHIT, CCS, CCS-P
THE ICD-10-CM EXTERNAL causes of morbidity tabular list in- cludes significant enhancements to the ICD-9-CM supplemen- tary classification of external causes of injury and poisonings (E800–E999). The ICD-10-CM list features category restructur- ing, reorganization, and major code expansion. This article provides an overview of chapter 20, “External Causes of Morbidity (V00–Y99),” in ICD-10-CM and highlights its coding guidelines. Chapter 20 Overview In ICD-10-CM external causes are incorporated into the main tabular listing within chapter 19, “Injury, Poisoning and Certain
Other Consequences of External Causes,” and chapter 20, “Ex-
ternal Causes of Morbidity.” Chapter 20 consists of categories
V00 through Y99 and is arranged in the following blocks:
x Accidents (V00–X58)
x Transport accidents (V00–V99)
x Other external causes of accidental injury (W00–X58)
x Intentional self-harm (X71–X83)
x Assault (X92–Y09)
x Event of undetermined intent (Y21–Y33)
x Legal intervention, operations of war, military operations,
and terrorism (Y35–Y38)
x Complications of medical and surgical care (Y62–Y84)
x Misadventures to patients during surgical and medi-
cal care (Y62–Y69)
x Medical devices associated with adverse incidents in
diagnostic and therapeutic use (Y70–Y82)
x Surgical and other medical procedures as the cause
of abnormal reaction of the patient, or of late complication,
without mention of misadventure at the time of the procedure (Y83–Y84)
x Supplementary factors related to causes of morbidity classified elsewhere (Y90–Y99)
The external causes of morbidity codes are used to capture
the cause, intent, place of occurrence, activity, and status of the
condition or injury. As with ICD-9-CM E codes, multiple external cause codes may be coded to fully identify all the components of the patient’s injury or health condition.
Many subcategories in ICD-9-CM have been given a specific
ICD-10-CM category, which expands the external cause codes
at the fourth-, fifth-, or sixth-character level. Take for example
ICD-9-CM code E917.0, In sports without subsequent fall. This
code equates to multiple codes in ICD-10-CM, including:
Certain ICD-10-CM chapter 20 categories require a seventh-
character extension to indicate whether the episode of care be-
ing identified is the initial, subsequent, or sequelae (a second-
