ICD-10 External Causes of Morbidity Codes Quiz: Injury Occurrence and Activity

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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?

A code from category W93

A code from category X93

A code from category Y93 (correct)

A code from category Z93

What is the general guideline for assigning place of occurrence, activity, and external cause status codes when using external cause codes?

Assign multiple place of occurrence, activity, and external cause status codes for each external cause code

Assign one place of occurrence code, one activity code, and one external cause status code per encounter, regardless of the number of external cause codes (correct)

Assign place of occurrence, activity, and external cause status codes only when the reporting format allows for it

Assign place of occurrence, activity, and external cause status codes only when the external cause code is for a transport accident

What is the exception to the general guideline for assigning place of occurrence codes?

There are no exceptions, the general guideline always applies

An additional place of occurrence code may be assigned if a new injury occurs during hospitalization (correct)

Multiple place of occurrence codes should be assigned if there are multiple external cause codes

Place of occurrence codes should only be assigned for transport accidents

What is the guideline for assigning external cause codes if the reporting format limits the number of external cause codes that can be used?

Report the code for the cause/intent most related to the principal diagnosis Signup and view all the answers

What is the priority order for assigning multiple external cause codes?

Child and adult abuse, terrorism events, cataclysmic events, transport accidents Signup and view all the answers

Where should activity and external cause status codes be assigned in relation to the causal (intent) external cause codes?

Activity and external cause status codes should be assigned after all causal (intent) external cause codes Signup and view all the answers

What is the guideline for assigning the first-listed external cause code when there are multiple external cause codes?

The first-listed external cause code should correspond to the cause of the most serious diagnosis Signup and view all the answers

How are confirmed cases of adult and child abuse, neglect, and maltreatment coded?

Using a combination of an assault code and a code from category Y07 Signup and view all the answers

How are events of undetermined intent coded?

Using external cause codes for accidental intent Signup and view all the answers

How are sequelae or late effects of external causes coded?

Using a new external cause code with the 7th character 'S' for sequela Signup and view all the answers

Which of the following statements about external cause codes is true?

External cause codes can be used with any code in the range of A00.0-T88.9, Z00-Z99. Signup and view all the answers

When assigning the 7th character for an external cause code, which statement is correct?

The 7th character should match the 7th character of the code assigned for the associated injury or condition. Signup and view all the answers

When assigning external cause codes, which of the following should be considered?

The cause, intent, place of occurrence, and activity of the patient at the time of the event should be considered. Signup and view all the answers

If only one external cause code can be recorded, which code should be assigned?

The code most related to the principal diagnosis. Signup and view all the answers

Which of the following statements about combination external cause codes is true?

Combination codes identify sequential events that result in an injury, such as a fall which results in striking against an object. Signup and view all the answers

When should a place of occurrence code (Y92) be assigned?

A place of occurrence code should be assigned only at the initial encounter for treatment. Signup and view all the answers

What should be done if the place of occurrence is not stated or not applicable?

Do not assign a place of occurrence code. Signup and view all the answers

When should an activity code (Y93) be assigned?

An activity code should be assigned only at the initial encounter for treatment. Signup and view all the answers

Which of the following statements about activity codes is true?

Only one activity code from Y93 should be recorded on a medical record. Signup and view all the answers

Which of the following statements about external cause codes is false?

External cause codes are only used for injuries and cannot be used for other health conditions. Signup and view all the answers

What should be done when the cause of an injury is identified by the Federal Government (FBI) as terrorism?

Assign a code from category Y38, Terrorism, as the first-listed external cause code. Signup and view all the answers

How should a sequela external cause code be used for subsequent visits?

Do not use a sequela external cause code for follow-up visits to assess healing or receive rehabilitative therapy, unless a late effect of the injury has been documented. Signup and view all the answers

When should code Y38.9, Terrorism, secondary effects, be assigned?

For conditions occurring subsequent to the terrorist event, but not for conditions due to the initial terrorist act. Signup and view all the answers

When should a code from category Y99, External cause status, be assigned?

Whenever any other external cause code is assigned, except for poisonings, adverse effects, misadventures, or late effects. Signup and view all the answers

How should a code from category Y99, External cause status, be used?

Only one code from Y99 should be recorded on a medical record for the initial encounter for treatment. Signup and view all the answers

When should a sequela external cause code not be used with a related current nature of injury code?

Never, a sequela external cause code should always be used with a related current nature of injury code. Signup and view all the answers

When should a code from category Y38, Terrorism, not be assigned?

When the cause of an injury is suspected to be the result of terrorism, but not confirmed. Signup and view all the answers

What should be done if the work status of the person at the time of the external cause event is not stated?

Do not assign a code from category Y99, External cause status. Signup and view all the answers

In what situation should more than one code from category Y38, Terrorism, be assigned?

When the injury is the result of more than one mechanism of terrorism. Signup and view all the answers

Which statement is true regarding the use of external cause codes?

External cause codes are not applicable for poisonings, adverse effects, misadventures, or late effects. Signup and view all the answers

What is the primary purpose of external cause codes in ICD-10-CM?

To capture data for injury research and prevention Signup and view all the answers

In what scenarios are providers required to report ICD-10-CM external cause codes?

Only if there is a state-based reporting mandate or payer requirement Signup and view all the answers

Which element is NOT captured by ICD-10-CM external cause codes?

Patient's occupation Signup and view all the answers

What is the national requirement for reporting ICD-10-CM external cause codes?

Reporting is voluntary unless mandated by a state or payer Signup and view all the answers

When should external cause codes be sequenced as the first-listed diagnosis?

Never as the principal diagnosis Signup and view all the answers

What type of information do external cause codes provide about an injury?

Cause, intent, place, activity, and person's status Signup and view all the answers

Why are providers encouraged to voluntarily report external cause codes?

To provide valuable data for injury research and prevention Signup and view all the answers

What is the significance of intent captured by external cause codes?

It indicates whether the injury was intentional or unintentional Signup and view all the answers

What happens if a provider fails to report ICD-10-CM external cause codes when required?

It may lead to missed opportunities for injury research and prevention Signup and view all the answers

Which term best describes when external cause codes should be reported?

As clinically appropriate and based on documentation Signup and view all the answers

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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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.

Chapter 20: External Causes of Morbidity Codes Quiz