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External causes of morbidity
NOTES:
This chapter permits the classification of environmental events and circumstances as the cause of injury, and other adverse effects. Where a code from this section is applicable, it is intended that it shall be used secondary to a code from another chapter of the Classification indicating the nature of the condition. Most often, the condition will be classifiable to Chapter 19, Injury, poisoning and certain other consequences of external causes (S00-T88). Other conditions that may be stated to be due to external causes are classified in Chapters I to XVIII. For these conditions, codes from Chapter 20 should be used to provide additional information as to the cause of the condition.
Chapter: 20: External causes of morbidity
V00-X58Accidents
NOTES:
 This section is structured in 12 groups. Those relating to land transport accidents (V00-V89) reflect the victim's mode of transport and are subdivided to identify the victim's 'counterpart' or the type of event. The vehicle of which the injured person is an occupant is identified in the first two characters since it is seen as the most important factor to identify for prevention purposes. A transport accident is one in which the vehicle involved must be moving or running or in use for transport purposes at the time of the accident.
INCLUDES:
 person changing tire on transport vehicle
 person examining engine of vehicle broken down in (on side of) road
USE ADDITIONAL:
 code to identify:
 Airbag injury (W22.1)
 Type of street or road (Y92.4-)
 Use of cellular telephone and other electronic equipment at the time of the transport accident (Y93.C-)
EXCLUDES1:
 Definitions related to transport accidents:
 (a) A transport accident (V00-V99) is any accident involving a device designed primarily for, or used at the time primarily for, conveying persons or good from one place to another.
 (b) A public highway [trafficway] or street is the entire width between property lines (or other boundary lines) of land open to the public as a matter of right or custom for purposes of moving persons or property from one place to another. A roadway is that part of the public highway designed, improved and customarily used for vehicular traffic.
 (c) A traffic accident is any vehicle accident occurring on the public highway [i.e. originating on, terminating on, or involving a vehicle partially on the highway]. A vehicle accident is assumed to have occurred on the public highway unless another place is specified, except in the case of accidents involving only off-road motor vehicles, which are classified as nontraffic accidents unless the contrary is stated.
 (d) A nontraffic accident is any vehicle accident that occurs entirely in any place other than a public highway. (e) A pedestrian is any person involved in an accident who was not at the time of the accident riding in or on a motor vehicle, railway train, streetcar or animal-drawn or other vehicle, or on a pedal cycle or animal. This includes, a person changing a tire, working on a parked car, or a person on foot. It also includes the user of a pedestrian conveyance such as a babystroller, ice-skates, skis, sled, roller skates, a skateboard, nonmotorized or motorized wheelchair, motorized mobility scooter, or nonmotorized scooter.
 (f) A driver is an occupant of a transport vehicle who is operating or intending to operate it.
 (g) A passenger is any occupant of a transport vehicle other than the driver, except a person traveling on the outside of the vehicle.
EXCLUDES2:
 V10-V19|Pedal cycle rider injured in transport accident||any non-motorized vehicle, excluding an animal-drawn vehicle, or a sidecar or trailer attached to the pedal cycle
 ||||||rupture of pedal cycle tire (W37.0)
Accidents
V20-V29Motorcycle rider injured in transport accident
INCLUDES:
 moped
 motorcycle with sidecar
 motorized bicycle
 motor scooter
EXCLUDES1:
 three-wheeled motor vehicle (V30-V39)
Motorcycle rider injured in transport accident
V30-V39Occupant of three-wheeled motor vehicle injured in transport accident
INCLUDES:
 motorized tricycle
 motorized rickshaw
 three-wheeled motor car
EXCLUDES1:
 all-terrain vehicles (V86.-)
 motorcycle with sidecar (V20-V29)
 vehicle designed primarily for off-road use (V86.-)
Occupant of three-wheeled motor vehicle injured in transport accident
V40-V49Car occupant injured in transport accident
INCLUDES:
 a four-wheeled motor vehicle designed primarily for carrying passengers
 automobile (pulling a trailer or camper)
EXCLUDES1:
 bus (V50-V59)
 minibus (V50-V59)
 minivan (V50-V59)
 motorcoach (V70-V79)
 pick-up truck (V50-V59) sport utility vehicle (SUV) (V50-V59)
Car occupant injured in transport accident
V50-V59Occupant of pick-up truck or van injured in transport accident
INCLUDES:
 a four or six wheel motor vehicle designed primarily for carrying passengers and property but weighing less than the local limit for classification as a heavy goods vehicle
 minibus
 minivan
 sport utility vehicle (SUV)
 truck
 van
EXCLUDES1:
 heavy transport vehicle (V60-V69)
Occupant of pick-up truck or van injured in transport accident
V60-V69Occupant of heavy transport vehicle injured in transport accident
INCLUDES:
 18 wheeler
 armored car
 panel truck
EXCLUDES1:
 bus
 motorcoach
Occupant of heavy transport vehicle injured in transport accident
V70-V79Bus occupant injured in transport accident
INCLUDES:
 motorcoach
EXCLUDES1:
 minibus (V50-V59)
Bus occupant injured in transport accident
V80-V89Other land transport accidents
V90-V94Water transport accidents
V95-V97Air and space transport accidents
EXCLUDES1:
 military aircraft accidents in military or war operations (Y36, Y37)
Air and space transport accidents
V98-V99Other and unspecified transport accidents
EXCLUDES1:
 vehicle accident, type of vehicle unspecified (V89.-)
Other and unspecified transport accidents
W00-X58Other external causes of accidental injury
EXCLUDES1:
 assault involving a fall (Y01-Y02)
 fall from animal (V80.-)
 fall (in) (from) machinery (in operation) (W28-W31)
 fall (in) (from) transport vehicle (V01-V99)
 intentional self-harm involving a fall (X80-X81)EXCLUDES2:
 at risk for fall (history of fall) Z91.81
 fall (in) (from) burning building (X00.-)
 fall into fire (X00-X04, X08-X09)
Other external causes of accidental injury
W20-W49Exposure to inanimate mechanical forces
EXCLUDES1:
 assault (X92-Y09)
 contact or collision with animals or persons (W50-W64)
 exposure to inanimate mechanical forces involving military or war operations (Y36.-, Y37.-)
 intentional self-harm (X71-X83)
Exposure to inanimate mechanical forces
W50-W64Exposure to animate mechanical forces
EXCLUDES1:
 Toxic effect of contact with venomous animals and plants (T63.-)
Exposure to animate mechanical forces
W65-W74Accidental non-transport drowning and submersion
EXCLUDES1:
 accidental drowning and submersion due to fall into water (W16.-)
 accidental drowning and submersion due to water transport accident (V90.-, V92.-)
EXCLUDES2:
 accidental drowning and submersion due to cataclysm (X34-X39)
Accidental non-transport drowning and submersion
W85-W99Exposure to electric current, radiation and extreme ambient air temperature and pressure
EXCLUDES1:
 exposure to:
 failure in dosage of radiation or temperature during surgical and medical care (Y63.2-Y63.5)
 lightning (T75.0-)
 natural cold (X31)
 natural heat (X30) natural radiation NOS (X39)
 radiological procedure and radiotherapy (Y84.2)
 sunlight (X32)
Exposure to electric current, radiation and extreme ambient air temperature and pressure
X00-X08Exposure to smoke, fire and flames
EXCLUDES1:
 arson (X97)
EXCLUDES2:
 explosions (W35-W40)
 lightning (T75.0-)
 transport accident (V01-V99)
Exposure to smoke, fire and flames
X10-X19Contact with heat and hot substances
EXCLUDES1:
 exposure to excessive natural heat (X30)
 exposure to fire and flames (X00-X09)
Contact with heat and hot substances
X30-X39Exposure to forces of nature
X50Overexertion and strenuous or repetitive movements
X52-X58Accidental exposure to other specified factors
X71-X83Intentional self-harm
INCLUSION TERMS:
 Purposely self-inflicted injury
 Suicide (attempted)
Intentional self-harm
X92-Y09Assault
INCLUDES:
 homicide
 injuries inflicted by another person with intent to injure or kill, by any means
EXCLUDES1:
 injuries due to legal intervention (Y35.-)
 injuries due to operations of war (Y36.-)
 injuries due to terrorism (Y38.-)
Assault
Y21-Y33Event of undetermined intent
INCLUSION TERMS:
 Undetermined intent is only for use when there is specific documentation in the record that the intent of the injury cannot be determined. If no such documentation is present, code to accidental (unintentional)
Event of undetermined intent
Y35-Y38Legal intervention, operations of war, military operations, and terrorism
Y62-Y84Complications of medical and surgical care
INCLUDES:
 complications of medical devices
 surgical and medical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure
EXCLUDES1:
 surgical and medical procedures as the cause of abnormal reaction of the patient, without mention of misadventure at the time of the procedure (Y83-Y84)
EXCLUDES2:
 breakdown or malfunctioning of medical device (during procedure) (after implantation) (ongoing use) (Y70-Y82)
Complications of medical and surgical care
Y70-Y82Medical devices associated with adverse incidents in diagnostic and therapeutic use
INCLUDES:
 breakdown or malfunction of medical devices (during use) (after implantation) (ongoing use)
EXCLUDES2:
 breakdown or malfunctioning of medical device (after implantation) (during procedure) (ongoing use) (Y70-Y82)
 later complications following use of medical devices without breakdown or malfunctioning of device (Y83-Y84)
 misadventure to patients during surgical and medical care, classifiable to (Y62-Y69)
 surgical and other medical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure (Y83-Y84)
Medical devices associated with adverse incidents in diagnostic and therapeutic use
Y83-Y84Surgical and other medical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure
EXCLUDES1:
 misadventures to patients during surgical and medical care, classifiable to (Y62-Y69)
EXCLUDES2:
 breakdown or malfunctioning of medical device (after implantation) (during procedure) (ongoing use) (Y70-Y82)
Surgical and other medical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure
Y90-Y99Supplementary factors related to causes of morbidity classified elsewhere
NOTES:
 These categories may be used to provide supplementary information concerning causes of morbidity. They are not to be used for single-condition coding.
Supplementary factors related to causes of morbidity classified elsewhere