ICD-10-CA Codes Partial Pick List

APPENDIX A PARTIAL PICK LIST OF INJURY AND SEQUELAE CODES (ICD-10-CA)

What are ICD-10 and ICD-10-CA? The International Statistical Classification of Diseases and Related Health Problems - Tenth Revision (ICD-10) is an international standard for reporting diseases, injuries, and causes of death developed by the World Health Organization (WHO).

ICD-10-CA is an enhanced version of ICD-10 developed by CIHI and is the classification facilities use to record problems, diagnoses, symptoms and other conditions necessitating contact with health care providers. Where Can I Get a Complete List of ICD-10-CA Codes? Visit the CIHI website for more information: cihi.ca

Providers and software vendors can purchase products and publications related to coding directly from CIHI at cihi.ca, including:

ICD-10-CA/CCI, 2010 (CD-ROM ? Single user). o This product is similar to CD-ROM encyclopedias. The infobase automatically indexes every word and users may find information quickly using the software's search engine.

Code Title Tables 2015 (for use with ICD-10-CA/CCI). o The code title tables include all the valid diagnosis and intervention codes and their descriptions.

PDF versions of the 2015 ICD-10-CA and CCI will become available prior to June 1, 2015. Stakeholders will be notified as soon as these are available.

ICD-10-CA and HCAI HCAI will only recognize valid ICD-10-CA codes. In many cases it will be important for users of HCAI to learn how to use the HCAI search code utility to locate valid ICD-10-CA codes. Without valid ICD-10-CA codes, HCAI users will be unable to submit forms to automobile insurers.

ICD-10-CA Code Structure

ICD Base (mandatory) ICD Sub-Category (Optional)

Position 1 Position 2-3 Position 4-6 Series Category Sub-Category

Series (position 1) The Series code represents a broad category of disease, condition, injury, disorder, or symptom. Codes are grouped within a series based on:

body system or anatomy (e.g. respiratory, circulatory) cause or etiology (e.g. injuries, infections) circumstances (e.g. pregnancy)

Appendix A

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APPENDIX A PARTIAL PICK LIST OF INJURY AND SEQUELAE CODES (ICD-10-CA)

Category (position 2-3) The Category code provides general details to describe the injury, disease, disorder, symptom or condition. The meaning of each position within Category Code varies from series to series.

Sub-Category (position 4-6) The Sub-Category code provides specific details related to the injury, disease, disorder, symptom or condition. Generally, this level of detail is not required for automobile insurers.

Conversion to 2015 Version of ICD-10-Ca

Periodically, HCAI will update the version of ICD-10-Ca and users should ensure they are using current code sets, which are available at hcaiinfo.ca.

Most Significant Injury/Sequelae Code

The code(s) selected by health practitioners is intended to reflect 1. The problem, injury, diagnosis or condition directly related to the automobile accident; and 2. The problem, injury, diagnosis or condition directly related to the automobile accident which is being addressed in the treatment plan or invoice.

When there is more than one injury/problem/sequelae list the most significant code first.

Physical Injury

Physical injury codes are primarily represented in Chapter XIX of the ICD-10-CA. The title of this chapter is "Injury, poisoning and certain other consequences of external causes" and the codes represented here include S00 to S99. These codes identify an injury involving one body part or region.

Injuries Involving Multiple Body Regions

Providers may wish to reference Chapter XIX of the ICD-10-CA when coding multiple injuries in a variety of body regions. The sub-section is called "Injuries involving multiple body regions" and the codes represented here include T00 to T07.

Sequelae of Injuries, of Poisoning and of Certain Other Consequences

Health providers may wish to refer to Chapter XIX of the ICD-10-CA to locate sequelae codes. The subsection to locate is called "Sequelae of injuries, of poisoning and of certain other consequences" and the codes represented here include T90 to T98. Each sequelae grouping can be related back to the original physical injury that led to the sequelae.

For example, if a claimant suffered an Injury to the Head as represented by the code for concussion (S06.0), the sequelae code for that injury can be found in the section called Sequelae of Injuries to the Head and the appropriate code for sequelae of concussion is T90.5. The ICD-10-CA specifically defines this code as representative of sequelae associated with the concussion code (S06.0).

Prior Conditions or Old Injuries

When coding injuries, problems and sequelae (Part 6 of the OCF 18, Part 5 of the OCF 23 and in the OCF 21), providers are asked to select a code that represents "injuries and sequelae that are the direct result of the automobile accident". Pre-existing conditions are captured elsewhere in the OCF forms. The Canadian

Appendix A

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APPENDIX A PARTIAL PICK LIST OF INJURY AND SEQUELAE CODES (ICD-10-CA)

Coding Standards for Version 20151 offers guidance on selecting the appropriate code. Current injuries are captured in Chapter XIX--Injury, Poisoning and Certain Other Consequences of External Causes [S00?T98]) while old injuries may be captured in the body system chapters, such as Chapter XIII--Diseases of the Musculoskeletal System and Connective Tissue [M00?M99]).

Example 1 (pg 329):

Current Injury related to auto collision is tear of meniscus of knee. Code = S83.2 (Tear of meniscus, current).

Nontraumatic (degenerative) tear of meniscus. Code = M23.3 (Other meniscus derangement including degenerate, detached or retained meniscus).

CIHI asks users to exercise caution when coding conditions that are described as repetitive, degenerative and/or from overuse. These codes are unrelated to a traumatic event and should not be classified as traumatic injuries.1 (pg 332)

Greatest Use of Resources

The most significant injury/sequelae code is the one code that identifies the problem, injury, diagnosis or condition directly related to the automobile accident which is or will be responsible for the greatest use of resources during the provision of care to the claimant in a given treatment plan or invoice. In a case of multiple injuries, the most significant injury/sequelae is the injury requiring the most services. If no diagnosis was made, the main symptom, abnormal finding or problem should be selected as the most significant injury and reported first in the list of injuries/problems.

1 Canadian Coding Standards for Version 2015 ICD-10 and CCI. Canadian Institute for Health Information. 2015.

Appendix A

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APPENDIX A PARTIAL PICK LIST OF INJURY AND SEQUELAE CODES (ICD-10-CA)

Appendix A ?Partial List of ICD-10-CA Codes

Chapter XIX ICD-10-CA Strains & Sprains

ICD-10 Code

S034 S091 S1340

S1341

S16 S233 S234 S290 S335 S336 S390 S434 S435 S436 S4378 S46 S460 S461 S462 S463 S534 S56 S560 S561

S562 S563

S564

S635 S636 S6370 S6371 S6372 S66 S660

S661

Description

Sprain and strain of jaw Injury of muscle and tendon of head Whiplash associated disorder [WAD1] with complaint of neck pain, stiffness or tenderness only Whiplash associated disorder [WAD2] with complaint of neck pain with musculoskeletal signs Injury of muscle and tendon at neck level Sprain and strain of thoracic spine Sprain and strain of ribs and sternum Injury of muscle and tendon at thorax level Sprain and strain of lumbar spine Sprain and strain of sacroiliac joint Injury of muscle and tendon of abdomen, lower back and pelvis Sprain and strain of shoulder joint Sprain and strain of acromioclavicular joint Sprain and strain of sternoclavicular joint Sprain and strain of other parts of shoulder girdle Injury of tendon at shoulder and upper arm level Injury of tendon of the rotator cuff of shoulder Injury of muscle and tendon of long head of biceps Injury of muscle and tendon of other parts of biceps Injury of muscle and tendon of triceps Sprain and strain of elbow Injury of muscle and tendon at forearm level Injury of flexor muscle and tendon on thumb at forearm level Injury of long flexor muscle and tendon or other finger(s) at forearm level Injury of other flexor muscle and tendon at forearm level Injury of extensor or abductor muscles and tendons of thumb at forearm level Injury of extensor muscle and tendon of other finger(s) at forearm level Sprain and strain of wrist Sprain and strain of finger(s) Sprain and strain of carpometacarpal (joint) of hand Sprain and strain of metacarpal (distal) (proximal) Midcarpal sprain and strain of hand Injury of muscle and tendon at wrist and hand level Injury of long flexor muscle and tendon of thumb at wrist and hand level Injury of flexor muscle and tendon of other finger at wrist and hand

Appendix A

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APPENDIX A PARTIAL PICK LIST OF INJURY AND SEQUELAE CODES (ICD-10-CA)

S662

S663

S664

S665

S731 S76 S760 S8340 S8341 S8350 S8351 S86 S860 S862

S868 S934 S935 S9350 S9351 S960

S961

Skin Wounds & NonExtensive Burns

S962 S968 S00 S000 S007 S01 S010 S017 S10 S100 S107 S11 S117 S20 S202

level Injury of extensor muscle and tendon of thumb at wrist and hand level Injury of extensor muscle and tendon of other finger at wrist and hand level Injury of intrinsic muscle and tendon of thumb at wrist and hand level Injury of intrinsic muscle and tendon of other finger at wrist and hand level Sprain and strain of hip Injury of muscle and tendon at hip and thigh level Injury of muscle and tendon of hip Sprain and strain of lateral collateral ligament of knee Sprain and strain of medial collateral ligament of knee Sprain and strain of anterior cruicate ligament of knee Sprain and strain of posterior cruciate ligament of knee Injury of muscle and tendon at lower leg level Injury of Achilles tendon Injury of muscle(s) and tendon(s) of anterior muscle group at lower leg level Injury of other muscles and tendons at lower leg level Sprain and strain of ankle Sprain and strain of toe(s) Sprain and strain of metatarsophalangeal joint Sprain and strain of (interphalangeal) joint of toe Injury of muscle and tendon of long flexor muscle of toe at ankle and foot level Injury of muscle and tendon on long extensor muscle of toe at ankle and foot level Injury of intrinsic muscle and tendon at ankle and foot level Injury of other muscles and tendons at ankle and foot level Superficial injury of head Superficial injury of scalp Multiple superficial injuries of head Open wound of head Open wound of scalp Multiple open wounds of head Superficial injury of neck Contusion of throat Multiple superficial injuries of neck Open wound of neck Multiple open wounds of neck Superficial injury of thorax Contusion of thorax

Appendix A

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APPENDIX A PARTIAL PICK LIST OF INJURY AND SEQUELAE CODES (ICD-10-CA)

Appendix A

S207 S21 S217 S30 S300 S301 S307 S310 S311 S3113 S317 S40 S400 S407 S410 S411 S417 S50 S500 S507 S51 S510 S60 S602 S607 S61 S617 S70 S700 S701 S707 S710 S711 S717 S80 S800 S801 S807 S808 S809 S81 S810 S8100 S8101

Multiple superficial injuries of thorax Open wound of thorax Multiple open wounds of thoracic wall Superficial injury of abdomen, lower back and pelvis Contusion of lower back and pelvis Contusion of abdominal wall Multiple superficial injuries of abdomen, lower back and pelvis Open wound of lower back and pelvis Open wound of abdominal wall Open wound of lower abdominal wall Multiple open wounds of abdomen, lower back and pelvis Superficial injury of shoulder and upper arm Contusion of shoulder and upper arm Multiple superficial injuries of shoulder and upper arm Open wound of shoulder Open wound of upper arm Multiple open wounds of shoulder and upper arm Superficial injury of forearm Contusion of elbow Multiple superficial injuries of forearm Open wound of forearm Open wound of elbow Superficial injury of wrist and hand Contusion of other parts of wrist and hand Multiple superficial injuries of wrist and hand Open wound of wrist and hand Multiple open wounds of wrist and hand Superficial injury of hip and thigh Contusion of hip Contusion of thigh Multiple superficial injuries of hip and thigh Open wound of hip Open wound of thigh Multiple open wounds of hip and thigh Superficial injury of lower leg Contusion of knee Contusion of other and unspecified parts of lower leg Multiple superficial injuries of lower leg Other superficial injuries of lower leg Superficial injury of lower leg, unspecified Open wound of lower leg Open wound of knee Open wound of knee, uncomplicated Open wound of knee, complicated

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APPENDIX A PARTIAL PICK LIST OF INJURY AND SEQUELAE CODES (ICD-10-CA)

S817 S90 S900 S903 S907 S910 S913 S917 T00 T01 T201 T205 T211 T215 T221

T225

T231 T235 T241 T245 T251 T255 T291

T295

Fractures, Dislocations & Extensive

T301 T305 S968 S02 S025 S025 S032 S026 S0262 S027 S030 S031 S032 S0910 S160 S222

Appendix A

Multiple open wounds of lower leg Superficial injury of ankle and foot Contusion of ankle Contusion of other and unspecified parts of foot Multiple superficial injuries of ankle and foot Open wound of ankle Open wound of other parts of foot Multiple open wounds of ankle and foot Superficial injuries involving multiple body regions Open wounds involving multiple body regions Burn of first degree of head and neck Corrosion of first degree of head and neck Burn of first degree of trunk Corrosion of first degree of trunk Burn of first degree of shoulder and upper limb, except wrist and hand Corrosion of first degree of shoulder and upper limb, except wrist and hand Burn of first degree of wrist and hand Corrosion of first degree of wrist and hand Burn of first degree of hip and lower limb, except ankle and foot Corrosion of first degree of hip and lower limb, except ankle and foot Burn of first degree of ankle and foot Corrosion of first degree of ankle and foot Burns of multiple regions, no more than first-degree burns mentioned Corrosions of multiple regions, no more than first-degree corrosions mentioned Burn of first degree, body region unspecified Corrosion of first degree, body region unspecified Injury of other muscles and tendons at ankle and foot level Fracture of skull and facial bones Fracture of tooth Fracture of tooth; broken tooth Dislocation of tooth Fracture of mandible Fracture of temporomandibular joint Multiple fractures involving skull and facial bone Dislocation of jaw Dislocation of septal cartilage of nose Dislocation of tooth Laceration of muscle and tendon of head Laceration of muscle and tendon at neck level Fracture of sternum

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APPENDIX A PARTIAL PICK LIST OF INJURY AND SEQUELAE CODES (ICD-10-CA)

Appendix A

S223 S224 S2900 S322 S323 S324 S325 S332 S334 S3900 S42 S420 S421 S422 S423 S424 S427 S430 S431 S432 S4600

S4670

S52 S520 S521 S5212 S522 S523 S524 S5250 S526 S527 S530 S531 S5600

S5610

S5630

S5640

S5670 S62

Fracture of rib Multiple fractures of ribs Laceration of muscle of tendon at thorax level Fracture of coccyx Fracture of ilium Fracture of acetabulum Fracture of pubis Dislocation of sacroiliac and sacrococcygeal joint Traumatic rupture of symphysis pubis Laceration of muscle and tendon of abdomen, lower back and pelvis Fracture of shoulder and upper arm Fracture of clavicle Fracture of scapula Fracture of upper end of humerus Fracture of shaft of humerus Fracture of lower end of humerus Multiple fractures of clavicle, scapula and humeru Dislocation of shoulder joint Dislocation of acromioclavicular joint Dislocation of sternoclavicular joint Laceration of tendon of the rotator cuff of shoulder Laceration of multiple muscles and tendons at shoulder and upper arm level Fracture of forearm Fracture of upper end of ulna Fracture of upper end of radius Fracture of radius with ulna, upper end Fracture of shaft of ulna Fracture of shaft of radius Fracture of shafts of both ulna and radius Colles' fracture Fracture of lower end of both ulna and radius Multiple fractures of forearm Dislocation of radial head Dislocation of elbow Laceration of flexor muscle and tendon of thumb at forearm level Laceration of long flexor muscle and tendon of other finger(s) at forearm level Laceration of extensor or abductor muscles and tendons of thumb at forearm level Laceration of extensor muscle and tendon of other finger(s) at forearm level Laceration of multiple muscles and tendons at forearm level Fracture at wrist and hand level

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