ICD-10 Code for Motor Vehicle Accident: Coding Auto Accident Injuries

Millions of people receive medical treatment for injuries every day. Injured persons often focus on their pain and the implications of their injuries, but don’t always consider the medical paperwork resulting from their treatment.

The International Classification of Diseases (ICD) codes attached to medical paperwork impact treatment and billing. Patients may need to learn about ICD-10 codes when they need medical care.

What Are ICD-10 Codes?

The origins of ICD codes stretch back to the 19th century. Statistician Jacque Bertillon introduced the Bertillon Classification of Causes of Death in 1891. These codes made it easier to develop statistical information about the various causes of death. The American Public Health Association recommended that the U.S. adopt Bertillon’s system in 1898.

The Centers for Disease Control and Prevention’s (CDC’s) National Center for Health Statistics expanded Bertillon’s system, producing a clinical modification known as ICD-10-CM. The Centers for Medicare and Medicaid Services (CMS) developed the ICD-10-PCS, the procedure coding system.

Who Uses ICD-10 Codes?

The World Health Organization (WHO) states that approximately 117 countries use ICD codes to report death statistics. Medical professionals, health information managers, and medical billers use the ICD-10 system every day. Insurance companies, CMS, and government organizations may also use ICD-10 codes when processing claims or making healthcare decisions. 

Personal injury attorneys may also refer to ICD-10 codes when filing client lawsuits. A car accident attorney will ensure the hospital used the correct codes when filing insurance claims to prevent complications with their client’s case. 

Suppose the ICD-10 code for motor vehicle collision is used instead of the ICD-10 code for motor vehicle accidents during pregnancy. In that case, a pregnant client may have difficulty pursuing compensation for complications with their pregnancy stemming from the accident.

Why Would a Patient Need To Understand ICD-10 Codes?

Typically, ICD-10 codes appear on the billing information sent to CMS or your insurance company. Healthcare providers also use ICD-10 codes when requesting pre-approval for future medical services.

You might need to look up ICD codes to ensure they’re accurate if your insurance company denied a claim or pre-approval request. ICD-10-CM and ICD-10-PCS codes have multiple characters. A medical biller or claims processor can mistakenly enter the wrong code, leading to financial complications if the incorrect code prompts your insurer to deny your claim.

Understanding ICD-10 Codes

Anyone who doesn’t use ICD-10 codes in their career may find the codes confusing. Fortunately, ICD-10 codes use a categorization system, enabling them to pass on specific information with a relatively short code.

Suppose you’re in an automobile accident. Your ICD-10 code will depend on your status and the nature of your injuries. Consequently, there isn’t one single “ICD-10 code for motor vehicle accident” for every MVA. Some MVAs would receive an “ICD-10 code for motor vehicle accident unspecified,” or a code identifying the type of accident, such as an “ICD-10 code for car driver injured in rollover accident.”

When creating an ICD-10 code for motor vehicle accident with injury, the first thing to consider is whether to use an S, T, or V code.

ICD S Codes: Localized Injury

ICD-10-CM S codes identify the area of your body where you sustained the injury, the injured body part, and details about the injury. Each S code begins with a correlation to the region where you sustained the injury. For example, neck injuries would receive a code beginning with S1. The third part in the code adds information about the injuries sustained. Suppose you had a cut on your neck. Your code would be S11. 

ICD T Codes: Multiple Body Parts

T codes identify injuries affecting multiple body parts. Examples include frostbite, poisonings, or multiple injuries. T07 refers to multiple body injuries, while T33 and T34 are codes for injuries from frostbite.

ICD V Codes: Transportation Accidents

V codes clarify the mode of transportation the person was using when injured. Since zero identifies the person as a pedestrian, pedestrians would receive a code beginning with V0. Your pedestrian accident attorney will want to ensure your ICD codes are correct while negotiating settlements with insurance companies and at-fault drivers. A car accident lawyer would want to ensure that a car passenger received a V4 code.

The third digit in V codes offers information about the type of accident. If a driver struck a deer, the third digit would be zero. If the vehicle collided with a train, the third digit would be five.

V codes also receive a fourth digit that clarifies the person’s role. The “ICD-10 code for motor vehicle accident driver” would have a zero for a non-traffic accident or five for a traffic accident. Non-traffic accidents are accidents that don’t occur while the vehicle operates on a roadway.

Specific ICD-10 Codes for Common Motor Vehicle Accident Injuries

So, what is the ICD-10 for car accident injuries? This abstract theory will become clearer with some examples. The following list includes some common ICD-10 codes for car crash injuries.

Concussion

The code for an intracranial brain injury is S06. A concussion is denoted by adding the code 0X plus a number that identifies the injury severity. Thus, a concussion with no loss of consciousness is S06.0X0, while the same injury with unconsciousness lasting up to 30 minutes is S06.0X1.

Whiplash

Whiplash is a neck injury in which the cervical spine is hyperextended. The ICD-10 whiplash from car accident code is S13.4 if the ligaments are sprained and S16.1 if the muscles or tendons are strained.

Fracture

The ICD-10 code for injury in vehicle collisions involving a fractured bone depends on which bone suffered trauma. A fractured clavicle, also known as a broken collarbone, is S42.00. On the other hand, a single fractured rib is S22.3, and multiple fractured ribs are S22.4.

Back Injury

The medical code for motor vehicle accident back injuries depends on the location and type of injury. A lower back ligament injury is S33.5, while a lower back muscle or tendon injury is S39.002. A muscle or tendon injury in the middle of the back, also called the thoracic spine, is S29.009.

The Seventh Character Extension: Initial, Subsequent, and Sequela

The seventh character code is used in some cases where the timing or sequence of the injury is important to the diagnosis. This code can include one of three letters.

• A represents the initial contact or phase of treatment.
• D represents a subsequent encounter during follow-up treatment or rehabilitation.
• S represents “sequela,” meaning the later phases or post-treatment.

These phases represent when the diagnosis or incidence of the injury occurred. Thus, suppose you broke your leg in a motorcycle accident. The motorcycle accident ICD-10 code for a fractured right femur shaft is S72.301. A doctor might record the code S72.3010A to indicate that it was diagnosed during the initial emergency room visit.

However, suppose you developed an infection during your treatment. Depending on the location, the doctor would append a D to the code for the infection. If you develop a blood clot later in your recovery that directly arose from the fracture, the doctor could append an S to the ICD-10 code for the blood clot.

The insurance company or subsequent treating physician can use the seventh character codes to understand the sequence of events during your injury.

Who Assigns ICD-10 Codes?

Medical facilities and healthcare providers assign ICD-10 codes when patients receive treatment. The ICD-10 codes can identify the patient’s diagnosis, the cause of their medical issues, and the treatment provided. These codes appear on paperwork processed by insurance companies. Insurance companies use these codes to determine whether to authorize payment for treatment.

What Are the Benefits of Using ICD-10 Codes?

ICD-10 codes bypass language barriers. With a few digits, insurance companies, statisticians, and medical professionals have access to clear medical information without using translators. 

Using a shared, standardized system ensures that people making healthcare decisions operate with the same information. The codes clarify causes of death or illness, enabling healthcare providers to identify viral outbreaks and pandemics. ICD-10 codes also ensure decision-makers have faster access to accurate information about health trends, enabling them to act promptly when health concerns arise.

How Can You Look Up ICD-10 Codes?

CMS provides access to several resources explaining ICD codes, including documents with commonly used codes. You can also learn about specific ICD codes and find codes via Find-a-Code.

The Role of a Personal Injury Lawyer in ICD-10 Coding 

A lawyer is not the person responsible for coding your diagnoses. However, your attorney can play three roles in motor vehicle accident ICD-10 coding. First, your lawyer will work with your doctors, therapists, and insurer to verify the accuracy of an ICD-10 code for car accident injuries. 

Accurate codes will explain how your injuries occurred, the full extent of the injury, and when it happened during the contact with the medical professional.

Second, your personal injury attorney can identify incorrect codes. These can lead to claim denials or reduced settlement offers. 

Suppose that a hospital incorrectly assigned ICD-10 traumatic injury from car crash codes when you were actually injured in a pedestrian accident. The incorrect code can cause delays in insurance claim payments.

Third, a car accident lawyer can challenge incorrect codes and advocate for your best interests in dealing with the insurer. For example, your lawyer can work with your doctor and the insurance company to ensure that the correct ICD-10 injury code for motor vehicle crashes is used to accurately reflect your doctor’s diagnosis.

ICD-10-CM vs. ICD-10-PCS: A Clearer Distinction

You will encounter two types of ICD-10 codes during your care. The first set of codes, called the ICD-10-CM, is used to diagnose injuries and conditions. This is where you will encounter the external cause code for car accident injuries. The goal of these codes is documentation for ICD-10 car accident injury or other trauma.

ICD-10-PCS codes are used in hospital settings to document surgical or other treatments performed on the patient. These codes are equally important because they tell insurers what services you received. 

However, these codes do not explain how to code auto accident injuries. ICD-10-PCS codes instead document the treatment provided.

FAQ

What Is the ICD-10 Code for a Passenger in a Car Accident?

The ICD-10 for motor vehicle accident occupants is V4 for a passenger car and V5 for a minivan, pickup truck, or SUV.

What Is the ICD-10 Code for Car Occupants Injured in Collisions?

The ICD-10 motor vehicle accident code for crash injuries is V494 for the driver and V495 for a passenger.

What Is the ICD-10 Code for a Traumatic Injury in a Car Crash?

V89 is the generic ICD-10 code for motor vehicle accident injuries.

What Is the ICD-10 Code for a Whiplash Injury?

S13.4 is the diagnosis code for auto accident injury involving cervical spine ligaments.

What Is the ICD-10 Code for a Pedestrian Hit by a Car?

The ICD-10 code for traffic collision injuries to a pedestrian is V09.2.

Citations:

ICD-10-CM Diagnosis Codes. (2022).
Importance of ICD. (2022).
Torrey, T. (2022). ICD 10 Codes and How to Look Them Up.
Understanding ICD-10 (ICD-10-CM). (2024).