December is the holiday season – the perfect time to decorate, indulge in tasty treats and celebrate and gather with loved ones. It’s no surprise that the hustle and bustle of the Christmas Season makes it a prime time for injuries and accidents to happen. Setting up holiday decorations like Christmas trees and candles, and scintillating outdoor lights can often result in unforeseen injuries, property loss or even death. In fact, many people get hurt amidst the joy and merriment of the holidays. This is a period when healthcare providers are also kept occupied with injured patients. While documenting such holiday injuries, healthcare providers and medical billing and coding companies must be fully aware about the associated medical codes and report the right diagnoses codes on their medical claims.

A recent analysis of data from the National Electronic Injury Surveillance System (NEISS) regarding holiday-related emergency room (ER) visits showed injuries tend to skyrocket in the weeks surrounding Christmas. Reports from the United States Consumer Product Safety Commission suggest that there were 407 Christmas-related admissions to health centers and emergency departments in December 2016. More than half of those admitted were women. The most common holiday activity related injuries include – injuries occurring from falls (falls due to Ice/snow, fall from ladder, fall from Christmas tree), cooking and baking injuries, lacerations caused by broken ornamental bulbs, injuries due to burns from lighting and other injuries from wrapping and unwrapping gifts.

Let’s take a look at the ICD-10 injury codes associated with the holiday season-related injuries –

Fall Due to Ice and Snow – Slipping hazards are quite common during cold temperatures, ice or snow. De-ice your driveway and walkways as soon as possible, if you don’t want to get hurt. Lay down ice melt products before it snows if possible. If it has already snowed, clear as much snow as you can before spreading your choice of de-icer. ICD-10 codes for falls include –

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

Fall from Ladder – Ladder safety is of paramount importance. It is estimated that about 50 percent of falls or injuries occur when someone actually falls off of the ladder or the roof while hanging lights. Set up your ladder properly and check it before using. Make sure none of the rungs are broken and that it does not exceed the recommended weight limit. Related ICD-10 codes are –

  • 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

Fall from Tree – These ICD-10 codes are used to report falls that occur while decorating a Christmas tree. This usually happens while adorning the tree with Christmas lights, stars or other ornaments on the higher branches. Avoid over-reaching higher branches and use a proper step ladder instead of using a chair or stool to do the job. Also, buy the right sized Christmas tree, so that you can avoid similar fixation injuries.

  • W14 – Fall from tree
    • W14.XXXA – Fall from tree, initial encounter
    • W14.XXXD – Fall from tree, subsequent encounter
    • W14.XXXS – Fall from tree, sequela

Shopping Mall as place of Injury – When people get crushed, pushed or stepped on by Christmas shopping crowds, use these codes –

  • Y92.5 – Trade and service area as the place of occurrence of the external cause
    • Y92.51 – Private commercial establishments as the place of occurrence of the external cause
    • Y92.52 – Service areas as the place of occurrence of the external cause
    • Y92.53 – Ambulatory health services establishments as the place of occurrence of the external cause
    • Y92.59 – Other trade areas as the place of occurrence of the external cause

Activity, Cooking and Baking – Hot fat, edible oils, alcohol, sharp knives and boiling water turn the kitchen into one of the most dangerous places during the holiday. Make sure to keep extra people out of the kitchen, especially children. Also, wipe any spills right away, so that no one slips and injures.

  • Y93.G – Activities involving food preparation, cooking and grilling
    • Y93.G1 – Activity, food preparation and clean up
    • Y93.G2 – Activity, grilling and smoking food
    • Y93.G3 – Activity, cooking and baking
    • Y93.G9 – Activity, other involving cooking and grilling

Overeating/excessive appetite – Consuming all those tempting treats, fatty foods, creamy sauces, cookies, mulled wine, champagne, and cocktails in large measures may cause heartburn and acid indigestion.

  • R12 – Heartburn
  • R63 – Symptoms and signs concerning food and fluid intake
    • R63.2 – Polyphagia

(This code can be used for symptoms from a single episode of overeating or repeated overeating)
 
Burns from Lighting – Incandescent Christmas lights can get hot enough to burn or ignite other decorations. LED lights are the best to use as they require less energy and do not give off heat. Never hang Christmas lights on a metal tree. The tree can become charged with electricity and cause electric shock and fire. Use these ICD-10 codes for reporting burns from lighting –

  • X08.8 – Exposure to other specified smoke, fire and flames
    • X08.8XXA – Exposure to other specified smoke, fire and flames, initial encounter
    • X08.8XXD – Exposure to other specified smoke, fire and flames, subsequent encounter
    • X08.8XXS – Exposure to other specified smoke, fire and flames, sequel

Activities involving arts and handcrafts – Injuries that occur while wrapping or unwrapping gifts – are the second most common types of holly, jolly mishaps that happen, particularly on Xmas day. Lacerations and puncture wounds occur when people use knives, scissors, and other sharp objects to wrap or open their presents. Related ICD-10 codes are –

  • Y93.D – Activities involving arts and handcrafts
    • Y93.D1 – Activity, knitting and crocheting
    • Y93.D2 – Activity, sewing
    • Y93.D3 – Activity, furniture building and finishing
    • Y93.D9 – Activity, other involving arts and handcrafts

Superficial Frostbite

  • T33 – Superficial frostbite
    • T33.0 – Superficial frostbite of head
    • T33.1 – Superficial frostbite of neck
    • T33.2 – Superficial frostbite of thorax
    • T33.3 – Superficial frostbite of abdominal wall, lower back and pelvis
    • T33.4 – Superficial frostbite of arm
    • T33.5 – Superficial frostbite of wrist, hand, and fingers
    • T33.6 – Superficial frostbite of hip and thigh
    • T33.7 – Superficial frostbite of knee and lower leg
    • T33.8 – Superficial frostbite of ankle, foot, and toe(s)
    • T33.9 – Superficial frostbite of other and unspecified sites

Activity, Sledding

  • Y93 – Activity codes
    • Y93.2 – Activities involving ice and snow
    • Y93.21 – Activity, ice skating
    • Y93.22 – Activity, ice hockey
    • Y93.23 – Activity, snow (alpine) (downhill) skiing, snowboarding, sledding, tobogganing and snow tubing
    • Y93.24 – Activity, cross country skiing
    • Y93.29 – Activity, other involving ice and snow

Other codes

  • T28.0XXA – Burn of mouth and pharynx, initial encounter
  • T75.4 – Electrocution (This can especially happen with strings of lights with bare wiring exposed)
  • T73.3xxA – Exhaustion due to excessive exertion, initial encounter
  • T78.40 – Allergy (unspecified) allergic reaction and hypersensitivity
  • Z62.891 – Sibling rivalry
  • Z63.1 – Problems in relationship with in-laws
  • Z72.820 – Sleep deprivation
  • F43.8 – Emotional stress
  • F10.929 – Alcohol use, unspecified with intoxication, unspecified
  • R42 – Dizziness and giddiness
  • X15.8 – Contact with other hot household appliances. (This code is applicable to contact with a cooker, kettle, or light bulbs)

Christmas is a festive season for enjoyment, but it can be quickly ruined by an injury. However, taking extra preventive measures can help people enjoy the Christmas holidays safely thereby avoiding injuries, property damage or even death.

Knowing the highly specific ICD-10 codes related to documenting injuries is critical for providers. Partnering with a reliable and experienced medical billing outsourcing company is important for physicians to ensure accurate and timely claim submissions.