External Cause in ICD-10-CM
Chapter 20, External Causes of Morbidityy

 There is no national requirement for mandatory ICD-10-CM external cause code reporting just as there was none in ICD-9-CM. However, a provider may be subject to a state-based external cause code reporting mandate or a provider may be required by a particular payer to report external cause codes.

Even though a provider may not be mandated to report these codes, providers are encouraged to report external cause codes as the codes provide beneficial information to areas such as research.

There are four different types of external cause codes with each code answering one of the following questions:

·         How did the injury or condition happen?

·         Where did it happen?

·         What was the patient doing when it happened?

·         Was it intentional or unintentional?        

• As many external cause codes as necessary to explain the patient’s condition to the fullest extent possible may be reported. 
• The external cause codes only need to be reported for the initial encounter with each provider or provider group
• The first cause code that should be reported is the one describes the cause or intent most closely related to the principal diagnosis. 
• The external cause codes for the following events take precedence over all other external cause codes, in the following order of importance:

1.      Child and adult abuse

2.      Terrorism events

3.      Cataclysmic events

4.      Transport accidents

 

 REFERENCE: ICD-10-CM Official Guidelines for Coding and Reporting

FY 2015