What you need to know about the codes healthcare providers use to classify slip-and-fall accidents

What you need to know about the codes healthcare providers use to classify slip-and-fall accidents

When you get treatment after a slip-and-fall accident, your healthcare providers will classify your injury using an ICD-10 code. Healthcare providers use ICD-10 codes to identify the external cause of a patient’s injury or health condition, facilitate data collection and research, and improve consistency in injury classification. ICD-10 codes also advise insurance companies of the reasons for a patient’s injury or medical condition, which may affect an insurer’s coverage determination.

Earley Law Group explains how ICD-10 medical codes are used to document slip-and-fall accidents.

What is an ICD-10 Code?

ICD-10 codes refer to alphanumeric codes in the International Classification of Diseases, Tenth Revision. The system is published and updated by the World Health Organization (WHO), though the Centers for Disease Control and Prevention’s National Center for Health Statistics handles the clinical modification of ICD-10 for use in the U.S. This publication provides a standardized system to code diseases and injuries for data-gathering purposes, which healthcare providers use when diagnosing patients.

General ICD-10 Code Categories for Slip and Fall

ICD-10 codes for slip- or trip-and-fall accidents include:

• W00: Fall due to ice and snow
• W01: Fall on same level from slipping, tripping, and falling
• W03: Other fall on same level due to collision with another person
• W04: Fall while being carried or supported by other persons
• W05: Fall from nonmoving wheelchair, nonmotorized scooter, or motorized mobility scooter
• W06: Fall from bed
• W07: Fall from chair
• W08: Fall from other furniture
• W09: Fall on/from playground equipment
• W10: Fall on/from stairs or steps
• W11: Fall on/from ladder
• W12: Fall on/from scaffolding
• W13: Fall from, out, or through building or structure
• W14: Fall from tree
• W15: Fall from cliff
• W16: Fall, jump, or dive into water
• W17: Fall from one level to another
• W18: Other slipping, tripping, or stumbling falls
• W19: Unspecified fall

Based on the ICD-10 code, insurance companies and others involved in a personal injury claim can determine information such as the location of a slip and fall, how it happened, and contributing factors.

Location-Specific Codes

Some of the ICD-10 codes for slip-and-fall accidents refer to the location of the fall. These codes include:

• W05: Fall from nonmoving wheelchair, nonmotorized scooter, or motorized mobility scooter
• W06: Fall from bed
• W07: Fall from chair
• W08: Fall from other furniture
• W09: Fall on/from playground equipment
• W10: Fall on/from stairs or steps
• W11: Fall on/from ladder
• W12: Fall on/from scaffolding
• W13: Fall from, out, or through building or structure (Subcodes cover falls involving balconies, bridges, roofs, floors, and windows)
• W14: Fall from tree
• W15: Fall from cliff
• W16: Fall, jump, or dive into water
• W17: Fall from one level to another (Subcodes include falls involving wells, storm drains, manholes, holes, empty swimming pools, and docks)

These ICD-10 codes help establish where your slip-and-fall accident happened, which can indicate that the owner or manager of that property may be liable.

Activity Code at the Time of Fall

Some ICD-10 code categories refer to the fall victim’s activities at the time of the fall, including:

• W01: Fall on same level from slipping, tripping, and falling — This code covers falls on a flat level or moving sidewalk, but not from a slightly elevated position, such as from a toilet or in a shower/bathtub.
• W03: Other fall on same level due to collision with another person — This covers a fall after colliding with another person, unless transported by other people. However, the code excludes getting pushed or crushed by a crowd/stampede or falling on a pedestrian conveyance.
• W04: Fall while being carried or supported by other persons — This code covers accidents that occur when people carrying or supporting a person accidentally drop them to the ground.

Using these ICD-10 codes can show what may have caused the slip and fall and that others may have been involved and potentially at fault.

External Cause Status Code

Some codes address an external cause of a slip or fall, including:

• W00: Fall due to ice and snow — This code includes pedestrians who slip on ice and snow. However, it excludes accidents involving falls on ice and snow involving a pedestrian conveyance.
• W18: Other slipping, tripping, or stumbling falls — This covers situations such as falling after bumping against an object, falling off the toilet, or falling in the shower or bathtub.
• W19: Unspecified fall — This covers all accidental falls without another covered cause or circumstance.

These ICD-10 codes may be relevant to your slip and fall because they can help identify how the accident happened.

Example Scenario

As an example of how ICD-10 codes work for slip-and-fall accidents, suppose a person slips and falls while walking down the entrance steps of a commercial building due to ice. When that person seeks medical treatment, their healthcare provider may diagnose the cause of their injury using ICD-10 code W00.1—fall from stairs and steps due to ice and snow.

W00.1 can help document the cause of the victim’s slip-and-fall injuries and tie them to the accident. This can indicate to the victim’s personal injury lawyer that they should investigate the icy steps. Insurers may also have a harder time arguing that something else caused the victim’s injuries because the healthcare provider already determined the cause. The correct ICD-10 code can launch the process of showing the property owner is at fault for the victim’s injuries because they didn’t keep the steps clear of ice.

This story was produced by Earley Law Group and reviewed and distributed by Stacker.