Medical Coding with ICD-10-CM: External Causes and Factors Influencing Health

Introduction

Focus on the last few chapters of ICD-10-CM chapter-specific guidelines
Topics: External Causes of Morbidity, Factors Influencing Health Status, and Codes for Special Purposes

Purpose: Provide additional data for injury research and prevention
- Capture how, where, and intention of the injury
Usage:
- Not mandatory, but encouraged for additional data
- Should never be a principal diagnosis
- Could be required by payers (e.g., insurance claims)
Application:
- Use with codes A00.0 through T88.9, Z00-Z99
- Describe cause, intent, place, and patient's status
Seventh Character Codes:
- A - Initial encounter, D - Subsequent encounter, S - Sequela
Assigning Codes: Use as many as needed related to the principal diagnosis

Selection: Guided by the alphabetic index and tabular listing
Circumstantial Codes:
- Not needed if external cause and intent are in another chapter
Place of Occurrence (Y92): Codes are secondary; used once unless new injury occurs
Activity Code (Y93): Used to describe the activity, only once at initial encounter
Status Codes (Y99): Indicate work status at the time of the causal event
Multiple External Causes: Priority sequence (abuse, terrorism, etc.)

Completion of chapter-specific guidelines
Upcoming sections include principal diagnosis selection and additional diagnoses
Encouragement to subscribe for updates on new guidelines