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International Classification of Disease (ICD) Codes for Injury



Contents

About Injury ICD Codes

ICD-10 Injury Mortality Code Matrix (Underlying Cause of Death)
ICD-10-CM Codes for Injury (Inpatient, Outpatient, and Physician Office Visits)

References

About Injury ICD Codes

ICD Stands for International Classification of Diseases. It is a coding system maintained by the World Health Organization and the U.S. National Center for Health Statistics used to classify causes of death on death certificates and diagnoses, injury causes, and medical procedures for hospital and emergency department visits. These codes are updated every decade or so to account for advances in medical technology. The U.S. has been using the 10th revision (ICD-10) to code causes of death since 1999. The 10th revision of the clinical modification (ICD-10-CM) has been in use for hospital, emergency department, and physician visits starting in October 2015. (1)

ICD codes for injury are grouped by both mechanism (such as poisoning, firearm, fall, and motor vehicle crash) as well as intent (such as unintentional and self-inflicted). Injury mechanism is typically grouped into at least 14 mechanisms of injury mortality. There are five categories of injury intent. Thus an injury with a mechanism of poisoning may be classified as unintentional (such as an unintentional drug overdose), intentional (homicide), self-inflicted (suicide), legal intervention, or undetermined.

ICD codes for injury are typically presented in a matrix with mechanism categories in the rows and intent categories in the columns. Certain mechanisms, such as motor vehicle, are often broken out into additional, more detailed categories. The ICD-10-CM codes are for injury are significantly different from the ICD-10 codes for injury mortality.

MechanismIntent
All InjuryUnintentionalSuicide/ Self-inflictedHomicide/ AssaultUndeterminedLegal Intervention/ Operations of War
1Cut/Pierce------
2Drowning/Submersion------
3Fall------
4Fire/Hot Object or Substance------
5Firearm------
6Machinery------
7Motor Vehicle, Traffic------
8Motor Vehicle, Non-traffic------
9Other Land Transport------
10Natural/Environmental------
11Overexertion------
12Poisoning------
13Struck By or Against------
14Suffocation------
15Other Specified and Unspecified------

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ICD-10 Injury Mortality Code Matrix

The ICD-10 External Cause of Injury codes are used in the Injury Mortality Query Module and have been grouped to be consistent with the External Cause of Injury Mortality Matrix for ICD-10 found on the NCHS website at http://www.cdc.gov/nchs/data/ice/icd10_transcode.pdf
MechanismIntent
All InjuryUnintentionalSuicide/ Self-inflictedHomicide/ AssaultUndeterminedLegal Intervention/ Operations of War
All InjuryV01-Y36, Y85-Y87, Y89, *U01-*U03V01-X59, Y85-Y86 X60-X84, Y87.0, *U03X85-Y09, Y87.1, *U01-*U02Y10-Y34, Y87.2, Y89.9 Y35-Y36, Y89 (.0-.1)
1.Cut/PierceW25-W29, W45, X78, X99, Y28, Y35.4W25-W29, W45X78X99Y28Y35.4
2.Drowning/SubmersionW65-W74, X71, X92, Y21W65-W74X71X92Y21-
3.FallW00-W19, X80, Y01, Y30W00-W19X80Y01Y30-
Fire/hot object or substance
4.Fire/Flame/SmokeX00-X09, X76, X97, Y26, Y36.3, *U01.3X00-X09X76X97, *U01.3Y26Y36.3
5.Hot Object/Substance, Caustic SubstanceX10-X19, X77, X98, Y27X10-X19X77X98Y27-
6.FirearmW32-W34, X72-X74, X93-X95, Y22-Y24, Y35.0, *U01.4W32-W34X72-X74X93-X95, *U01.4Y22-Y24Y35.0
7.MachineryW24, W30-W31W24, W30-W31----
All Transport
Motor Vehicle, Traffic
8.Occupant InjuredV30-V39 (.4-.9)
V40-V49 (.4-.9)
V50-V59 (.4-.9)
V60-V69 (.4-.9)
V70-V79 (.4-.9)
V83-V86 (.0-.3)
V30-V39 (.4-.9)
V40-V49 (.4-.9)
V50-V59 (.4-.9)
V60-V69 (.4-.9)
V70-V79 (.4-.9)
V83-V86 (.0-.3)
----
9.Motorcyclist InjuredV20-V28 (.3-.9), V29 (.4-.9)V20-V28 (.3-.9), V29 (.4-.9)----
10.Pedal Cyclist InjuredV12-V14 (.3-.9) , V19 (.4-.6)V12-V14 (.3-.9) , V19 (.4-.6)----
11.Pedestrian InjuredV02-V04 (.1, .9) V09.2V02-V04 (.1, .9) V09.2----
12.Other and UnspecifiedV80 (.3-.5), V81.1, V82.1 - other
V87 (.0-.8), V89.2 - unspecified
V80 (.3-.5), V81.1, V82.1 - other
V87 (.0-.8), V89.2 - unspecified
----
Motor Vehicle, Non-traffic
13.Pedal Cyclist, OtherV10-V11, V12-V14 (.0-.2), V15-V18, V19 (.0-.3, .8, .9)V10-V11, V12-V14 (.0-.2), V15-V18, V19 (.0-.3, .8, .9)----
14.Pedestrian, OtherV01, V02-V04 (.0), V05, V06, V09 (.0, .1, .3, .9)V01, V02-V04 (.0), V05, V06, V09 (.0, .1, .3, .9)----
15.Other Motor VehicleV20-V28 (.0-.2), V29 (.0-.3)
V30-V39 (.0-.3)
V40-V49 (.0-.3)
V50-V59 (.0-.3)
V60-V69 (.0-.3)
V70-V79 (.0-.3)
V81-V82 (.0)
V83-V86 (.4-.9)
V88 (.0-.8), V89.0
V20-V28 (.0-.2), V29 (.0-.3)
V30-V39 (.0-.3)
V40-V49 (.0-.3)
V50-V59 (.0-.3)
V60-V69 (.0-.3)
V70-V79 (.0-.3)
V81-V82 (.0)
V83-V86 (.4-.9)
V88 (.0-.8), V89.0
----
16.Other Land TransportV80 (.0-.2, .6-.9), V81-V82 (.2-.9), V87.9, V88.9, V89 (.1, .3, .9), X82, Y03, Y32 V80 (.0-.2, .6-.9), V81-V82 (.2-.9), V87.9, V88.9, V89 (.1, .3, .9)X82Y03Y32-
17.Other TransportV90-V99 , Y36.1, *U01.1V90-V99-*U01.1-Y36.1
18.Natural/EnvironmentalW42, W43, W53-W64, W92-W99, X20-X39, X51-X57W42, W43, W53-W64, W92-W99, X20-X39, X51-X57----
19.OverexertionX50X50----
20.PoisoningX40-X49, X60-X69, X85-X90, Y10-Y19, Y35.2, *U01 (.6-.7)X40-X49X60-X69X85-X90, *U01 (.6-.7)Y10-Y19Y35.2
21.Struck By or AgainstW20-W22, W50-W52, X79, Y00, Y04, Y29, Y35.3W20-W22, W50-W52X79Y00, Y04Y29Y35.3
22.SuffocationW75-W84, X70, X91, Y20W75-W84X70X91Y20-
23.Other Specified and UnspecifiedW23, W35-W41, W44, W49 W85-W91, X58-X59, X75, X81, X83-X84, X96, Y02, Y05-Y09, Y25, Y31, Y33-Y34, Y35 (.1, .5-.7) Y36 (.0, .2, .4-.9), Y85-Y87.2, Y89 (.0, .1, .9), *U01 (.0, .2, .5, .8, .9), *U02, *U03 (.0, .9)
Other Specified, classifiableW23, W35-W41, W44, W49 W85-W91, Y85X75, X81, *U03.0 X96, Y02, Y05-Y07, *U01 (.0, .2, .5)Y25, Y31Y35 (.1, .5) Y36 (.0, .2, .4-.8)
Other Specified, NECX58, Y86X83, Y87.0Y08, Y87.1, *U01.8, *U02Y33, Y87.2Y35.6, Y89 (.0, .1)
UnspecifiedX59X84, *U03.9Y09, *U01.9Y34, Y89.9Y35.7 Y36.9
Adverse Effects (Not included in All Injury above)
1.Adverse Drug EventsY40-Y59, Y88.0Y40-Y59, Y88.0----
2.Medical Procedures and Medical CareY60-Y84, Y88 (.1-.3)Y60-Y84, Y88 (.1-.3)----

The new ICD-10 codes for terrorism (bolded and preceded with '*') are not used internationally.

For ICD-9 Injury Mortality codes, visit the ICD-9 Injury Matrix

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ICD-10-CM (clinical modification) Injury Codes

The ICD-10-CM codes are used for inpatient, outpatient, and physician office visit diagnoses and are used in the NM-IBIS Hospital Inpatient (HIDD) and Emergency Department (ED) query systems for injury diagnoses. The ICD-10-CM codes for injury are significantly different from the ICD-10 codes for injury mortality.

Injury mechanism and intent categories are often referred to as "external causes" because they refer to the external forces that were applied to the body. The ICD-10 codes for external causes are used to classify injury deaths and may also be used for Hospital Inpatient (HIDD) and Emergency Department (ED) visits. In addition, the ICD-10-CM system also has injury diagnosis (or nature of injury) codes that are used to classify injuries by body region (for example, head, leg, chest) and nature of injury (for example, fracture, laceration, solid organ injury, poisoning). (2)

The case definition for "injury" using ICD-10-CM includes only records that have been coded as initial encounters or in active treatment (7th digit of ICD-10-CM code is A, B, or C and records that are missing the 7th digit). Visits for subsequent encounters (e.g., follow-up, wound care, delayed healing, sequela) are excluded from the case definition. Any given hospital or ED encounter must first meet the case definition of an injury before the injury mechanism or intention are considered.(3)

The case definition for injury hospital and ED visits laso specifies "non-fatal" injuries, and thus excludes encounters with a discharge status of "expired." The hospital and emergency department data queries in NM-IBIS include records for in-hospital deaths, but these may be excluded when building a custom query.

ICD-10-CM codes for the external cause of the injury are codes beginning with V, W, X, and Y. These codes are like the "E" codes in ICD version 9. For ICD-10-CM codes beginning with V, W, X, and Y, different ranges of codes define the injury mechanism and intention (e.g., visits with diagnosis codes in the X10-X19 range were visits for unintentional burns). The external cause of injury codes are not billable codes and will never appear in the primary diagnosis field. They may appear in the external cause fields, or in any of the other diagnosis fields.

ICD-10-CM codes beginning with S and T are injury diagnosis codes for the anatomical nature of the injury. The T codes define the poisoning (including drug overdose) diagnoses. ICD-10-CM injury codes may appear in any of the diagnosis fields. The S and T diagnosis codes also include information on the injury intention, which is usually coded in the 6th digit, with 1=unintentional, 2=self harm, 3=assault and 4=undetermined. However, for some "T" codes, the intention code appears in the 5th place.

Because the injury diagnosis and external cause codes may appear in any of the diagnosis fields, all 18 diagnosis fields must be searched for any given injury diagnosis code. As a result, neither the list of intentions nor the list of mechanisms provides for a set of mutually exclusive categories of hospital visits. As a result, a single visit may be coded into multiple intention or mechanism categories.

Injury Matrix for ICD-10-CM, NCHS, Dec 2019 for use with inpatient hospital and ED data.

For more general information on underlying cause of death ICD codes, visit the IBIS help page on ICD Codes and NCHS code lists.



References


1. International Classification of Diseases,Tenth Revision (ICD-10), National Center for Health Statistics, Centers for Disease Control and Prevention. Downloaded from https://www.cdc.gov/nchs/icd/icd10.htm on 7/22/2023.
2. ICD Injury Codes and Matrices, National Center for Health Statistics, Centers for Disease Control and Prevention. Downloaded from https://www.cdc.gov/nchs/injury/injury_matrices.htm on 7/22/2023.
3. Hedegaard H, Johnson RL, Garnett MF, Thomas KE. The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) external cause-of-injury framework for categorizing mechanism and intent of injury. National Health Statistics Reports; no 136. Hyattsville, MD: National Center for Health Statistics. 2019. Downloaded on January 16, 2020 from https://www.cdc.gov/nchs/data/nhsr/nhsr136-508.pdf.


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