ICD-10 Codes for the Holiday Season

by | Published on Dec 6, 2022 | Medical Coding

Holiday Season
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Christmas preparation, holiday preparation, family gatherings, gatherings with loved ones, all make holidays memorable. However, it can also be a time of injuries, accidents and illnesses. Holiday injuries can keep physicians, emergency rooms, and urgent care centers quite busy during this time of the year. Treatments provided can be reimbursed by submitting clean medical claims with the correct ICD-10 codes. Providers can rely on professional medical coding companies to report these injuries on the medical claims using accurate medical codes.

2022 Holiday Injuries and Related Medical Codes

Check out some of the most common injuries during the holiday season and the ICD-10 codes related to them.

ICD 10 Codes for the Holiday Season Injuries

Fall Injuries

Falling from a Ladder

  • W11 Fall on and from ladder
    • W11.XXXA Fall on and from ladder, initial encounter
    • W11.XXXD Fall on and from ladder, subsequent encounter
    • W11.XXXS Fall on and from ladder, sequela

Most people use a ladder to complete their holiday decorations indoors and outdoors. Fall from ladder can cause many injuries including broken bones, sprains or fractures, head injuries or persistent headaches, neck and back pain, low back pain, or even swelling, bruising and internal bleeding. The Consumer Product Safety Commission has reported that approximately 160 decorating-related injuries occur each day in the U.S. during the holiday season.

All such injuries can be billed on the medical claims using relevant ICD-10 codes

  • M54.5 Low back pain
    • M54.50 …… unspecified
    • M54.51 Vertebrogenic low back pain
    • M54.59 Other low back pain
  • M54.6 Pain in thoracic spine
  • M84.4 Pathological fracture, not elsewhere classified
    • M84.40 Pathological fracture, unspecified site
    • M84.41 Pathological fracture, shoulder
      • M84.411 Pathological fracture, right shoulder
      • M84.412 Pathological fracture, left shoulder
      • M84.419 Pathological fracture, unspecified shoulder
  • M54.2 Cervicalgia
  • M54.3 Sciatica
  • S09.9 Unspecified injury of face and head

To avoid fall injuries, it is important to check whether the ladder one uses is in good working condition. Ideally, move the base of the ladder one foot away from the wall, while climbing heights.

Slipping on Ice

  • W00 Fall due to ice and snow
    • W00.0 Fall on same level due to ice and snow
      • W00.0XXA …… initial encounter
      • W00.0XXD …… subsequent encounter
      • W00.0XXS …… sequela
    • W00.1 Fall from stairs and steps due to ice and snow
      • W00.1XXA …… initial encounter
      • W00.1XXD …… subsequent encounter
      • W00.1XXS …… sequela
    • W00.2 Other fall from one level to another due to ice and snow
      • W00.2XXA …… initial encounter
      • W00.2XXD …… subsequent encounter
      • W00.2XXS …… sequela
    • W00.9 Unspecified fall due to ice and snow
      • W00.9XXA …… initial encounter
      • W00.9XXD …… subsequent encounter
      • W00.9XXS …… sequela

Cold weather, snow and ice fall can cause arthritis flares and dangerous slips and falls that can result in numerous orthopedic injuries such as cuts and bruises, concussion, sprains and strains, fractures, back, neck and shoulder injuries, stretching and tearing of tendons, muscles, and ligaments, and more. Orthopedic specialists report such injuries using relevant codes.

  • S06 Intracranial injury
    • S06.0 Concussion
  • S02 Fracture of skull and facial bones
  • S03 Dislocation and sprain of joints and ligaments of head

To prevent slip and fall injuries, wear proper footwear and go slow in snowy walkways. Also avoid any distractions when walking.

Toy Related Injuries

CPSC has reported that in 2021 there were more than 152,000 toy-related, emergency department-treated injuries for children younger than 15 years of age, including two deaths. Toy related injuries mainly include lacerations and contusions, and abrasions to the child’s face and head. Injuries also occur from non-motorized scooters and other riding toys.

  • S01.81 Laceration without foreign body of other part of head
    • S01.81XA …… initial encounter
    • S01.81XD …… subsequent encounter
    • S01.81XS …… sequela
  • S01.82 Laceration with foreign body of other part of head
    • S01.82XA …… initial encounter
    • S01.82XD …… subsequent encounter
    • S01.82XS …… sequela
  • S01.83 Puncture wound without foreign body of other part of head
    • S01.83XA …… initial encounter
    • S01.83XD …… subsequent encounter
    • S01.83XS …… sequela

Parents need to consider age guidance and safety tips, while choosing toys for their kids. Also buy helmets while buying scooters.

Fire Injuries

Fires and burns associated with holiday decorations can be related to candle lighting, cooking and baking or even careless use of electronic equipment. Any distractions while preparing and cooking turkey, sweet potatoes, and pumpkin pie for a delicious Thanksgiving dinner can also result in residential fires. Christmas tree fires are also dangerous, when left unnoticed. House fires can be started by candles as well. The National Safety Council has reported that just over half of home fires in December are started by candles.

  • T30 Burn and corrosion, body region unspecified
    • T30.0 Burn of unspecified body region, unspecified degree
    • T30.4 Corrosion of unspecified body region, unspecified degree
  • T31 Burns classified according to extent of body surface involved
  • X08.8 Exposure to other specified smoke, fire and flames
    • X08.8XXA …… initial encounter
    • X08.8XXD …… subsequent encounter
    • X08.8XXS …… sequela

Do not leave Christmas tree lights and candles on, when no one is around. Keep burning candles away from flammable items. Never leave a candle burning in an unattended room. Turn off the oven or any other electric equipment as soon as the task is done.

Automobile Accidents

Drunken, careless driving also cause accidents. Car crashes often result in serious injury and death. Alcohol-impaired driving during celebrations is the main cause of accidents.

  • V89 Motor- or nonmotor-vehicle accident, type of vehicle unspecified
    • V89.0 Person injured in unspecified motor-vehicle accident, nontraffic
      • V89.0XXA …… initial encounter
      • V89.0XXD …… subsequent encounter
      • V89.0XXS …… sequela
    • V89.1 Person injured in unspecified nonmotor-vehicle accident, nontraffic
      • V89.1XXA …… initial encounter
      • V89.1XXD …… subsequent encounter
      • V89.1XXS …… sequela
    • V89.2 Person injured in unspecified motor-vehicle accident, traffic
      • V89.2XXA …… initial encounter
      • V89.2XXD …… subsequent encounter
      • V89.2XXS …… sequela
    • V89.3 Person injured in unspecified nonmotor-vehicle accident, traffic
      • V89.3XXA …… initial encounter
      • V89.3XXD …… subsequent encounter
      • V89.3XXS …… sequela
    • V89.9 Person injured in unspecified vehicle accident

Drivers should avoid distractions while driving, and should get plenty of sleep to avoid fatigue and drive better.

Some other injuries include cutting oneself with a knife or scissors, while decorating the Christmas tree or while cooking. Food borne illnesses are also a concern during celebrations.

  • Z91.01 Food allergy status
    • Z91.010 Allergy to peanuts
    • Z91.011 Allergy to milk products
    • Z91.012 Allergy to eggs
    • Z91.013 Allergy to seafood
    • Z91.014 Allergy to mammalian meats
    • Z91.018 Allergy to other foods
  • Z91.02 Food additives allergy status

Any treatments that emergency doctors or other specialists provide can be reported on the medical claims using the right ICD and CPT codes. Make sure to partner with an experienced medical billing and coding company to submit claims on-time.

Loralee Kapp

Since joining our RCM Division in October 2021, Loralee, who is HIT Certified (Health Information Technology/Health Information Management), brings her extensive expertise in medical coding and Health Information Management practices to OSI.

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