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Questions and Answers
Which code is appropriate to use with external cause and intent codes if identifying the activity provides additional information about the event?
What is the general guideline for assigning place of occurrence, activity, and external cause status codes when using external cause codes?
What is the exception to the general guideline for assigning place of occurrence codes?
What is the guideline for assigning external cause codes if the reporting format limits the number of external cause codes that can be used?
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What is the priority order for assigning multiple external cause codes?
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Where should activity and external cause status codes be assigned in relation to the causal (intent) external cause codes?
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What is the guideline for assigning the first-listed external cause code when there are multiple external cause codes?
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How are confirmed cases of adult and child abuse, neglect, and maltreatment coded?
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How are events of undetermined intent coded?
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How are sequelae or late effects of external causes coded?
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Which of the following statements about external cause codes is true?
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When assigning the 7th character for an external cause code, which statement is correct?
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When assigning external cause codes, which of the following should be considered?
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If only one external cause code can be recorded, which code should be assigned?
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Which of the following statements about combination external cause codes is true?
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When should a place of occurrence code (Y92) be assigned?
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What should be done if the place of occurrence is not stated or not applicable?
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When should an activity code (Y93) be assigned?
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Which of the following statements about activity codes is true?
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Which of the following statements about external cause codes is false?
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What should be done when the cause of an injury is identified by the Federal Government (FBI) as terrorism?
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How should a sequela external cause code be used for subsequent visits?
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When should code Y38.9, Terrorism, secondary effects, be assigned?
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When should a code from category Y99, External cause status, be assigned?
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How should a code from category Y99, External cause status, be used?
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When should a sequela external cause code not be used with a related current nature of injury code?
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When should a code from category Y38, Terrorism, not be assigned?
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What should be done if the work status of the person at the time of the external cause event is not stated?
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In what situation should more than one code from category Y38, Terrorism, be assigned?
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Which statement is true regarding the use of external cause codes?
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What is the primary purpose of external cause codes in ICD-10-CM?
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In what scenarios are providers required to report ICD-10-CM external cause codes?
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Which element is NOT captured by ICD-10-CM external cause codes?
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What is the national requirement for reporting ICD-10-CM external cause codes?
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When should external cause codes be sequenced as the first-listed diagnosis?
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What type of information do external cause codes provide about an injury?
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Why are providers encouraged to voluntarily report external cause codes?
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What is the significance of intent captured by external cause codes?
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What happens if a provider fails to report ICD-10-CM external cause codes when required?
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Which term best describes when external cause codes should be reported?
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Study Notes
General External Cause Coding Guidelines
- External cause codes can be used with any code in the range of A00.0-T88.9, Z00-Z99 to represent a health condition due to an external cause.
- External cause codes are not limited to injuries, but also applicable to infections or diseases due to an external source.
Assigning External Cause Codes
- Assign the external cause code with the appropriate 7th character (initial encounter, subsequent encounter or sequela) for each encounter for which the injury or condition is being treated.
- Most categories in chapter 20 have a 7th character requirement for each applicable code.
Use of External Cause Codes
- Use the full range of external cause codes to completely describe the cause, intent, place of occurrence, and if applicable, the activity of the patient at the time of the event, and the patient's status.
- Assign as many external cause codes as necessary to fully explain each cause.
Selection of External Cause Codes
- The selection of the appropriate external cause code is guided by the Alphabetic Index of External Causes and by Inclusion and Exclusion notes in the Tabular List.
- An external cause code can never be a principal (first-listed) diagnosis.
Combination External Cause Codes
- Certain external cause codes are combination codes that identify sequential events that result in an injury.
- The combination external cause code used should correspond to the sequence of events regardless of which caused the most serious injury.
No External Cause Code Needed
- No external cause code from Chapter 20 is needed if the external cause and intent are included in a code from another chapter.
Place of Occurrence Guideline
- 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.
- A place of occurrence code is assigned only once, at the initial encounter for treatment.
Activity Code
- Assign a code from category Y93, Activity code, to describe the activity of the patient at the time the injury or other health condition occurred.
- An activity code is used only once, at the initial encounter for treatment.
Place of Occurrence, Activity, and Status Codes
- When applicable, place of occurrence, activity, and external cause status codes are sequenced after the main external cause code(s).
- Generally, there should be only one place of occurrence code, one activity code, and one external cause status code assigned to an encounter.
Multiple External Cause Coding Guidelines
- More than one external cause code is required to fully describe the external cause of an illness or injury.
- The assignment of external cause codes should be sequenced in the following priority:
- External codes for child and adult abuse take priority over all other external cause codes.
- External cause codes for terrorism events take priority over all other external cause codes except child and adult abuse.
- External cause codes for cataclysmic events take priority over all other external cause codes except child and adult abuse and terrorism.
Child and Adult Abuse Guideline
- Adult and child abuse, neglect, and maltreatment are classified as assault.
- Any of the assault codes may be used to indicate the external cause of any injury resulting from the confirmed abuse.
Unknown or Undetermined Intent Guideline
- If the intent (accident, self-harm, assault) of the cause of an injury or other condition is unknown or unspecified, code the intent as accidental intent.
- All transport accident categories assume accidental intent.
Sequelae (Late Effects) of External Cause Guidelines
- Sequelae are reported using the external cause code with the 7th character “S” for sequela.
- These codes should be used with any report of a late effect or sequela resulting from a previous injury.
Terrorism Guidelines
- When the cause of an injury is identified by the Federal Government (FBI) as terrorism, the first-listed external cause code should be a code from category Y38, Terrorism.
- Use additional code for place of occurrence (Y92.-).
External Cause Status
- A code from category Y99, External cause status, should be assigned whenever any other external cause code is assigned for an encounter.
- Assign a code from category Y99, External cause status, to indicate the work status of the person at the time the event occurred.
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Description
Test your knowledge on external causes of morbidity codes and their use in injury research and evaluation. Learn about how to sequence external causes of morbidity codes and their importance in injury prevention strategies.