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2025 ICD-10-CM code W16.211D

Fall in a filled bathtub causing drowning and submersion, subsequent encounter.

Refer to the official ICD-10-CM coding guidelines for detailed instructions on selecting the appropriate codes. The guidelines emphasize the importance of using secondary codes to indicate the nature of the injury or condition, and provide guidance on sequencing codes.

Modifiers may be applicable depending on the circumstances of the encounter and services provided. Consult the official guidelines for appropriate modifier usage.

Medical necessity is established by the presence of significant injury or condition resulting from the drowning and/or submersion, necessitating medical intervention.This could include respiratory compromise, hypothermia, or other complications.Appropriate medical evaluation, treatment, and monitoring are medically necessary.

The clinical responsibility involves assessing the patient's condition resulting from the drowning or submersion, providing appropriate treatment (e.g., resuscitation, oxygen therapy, monitoring vital signs), and managing any complications.Documentation should clearly indicate the circumstances of the event and the resulting injuries.

IMPORTANT:Related codes may include those specifying the nature of the injury (e.g., respiratory failure due to drowning) from other chapters, and codes from chapter 20 indicating the circumstances of the accident.W16.211A (initial encounter), W16.211S (sequela).

In simple words: This code is for a patient who had a second or later doctor visit after a fall in a full bathtub that caused them to drown or be submerged under water.

This code classifies a subsequent encounter for a patient who experienced drowning and submersion as a result of falling into a filled bathtub.It is used to indicate that the injury is a consequence of an external cause (the fall).This code should be used in conjunction with codes from other chapters specifying the nature of the injury or condition resulting from the fall.

Example 1: A 70-year-old female patient falls in a filled bathtub, resulting in drowning. She is admitted to the hospital for treatment. This is a subsequent encounter for continued care., A 3-year-old child falls into a filled bathtub, leading to submersion and subsequent respiratory distress. The child is brought to the emergency department, and this is a subsequent encounter for ongoing monitoring and treatment of respiratory issues., An elderly patient with impaired mobility falls in a filled bathtub, leading to submersion and consequent hypothermia. This represents a subsequent visit for evaluation and management of the hypothermia.

Comprehensive documentation should include a detailed description of the event, patient's age and underlying conditions, vital signs, initial and subsequent treatments, any complications (e.g., pneumonia, neurological deficits), and the duration of submersion.Hospital admission notes, emergency department records, and follow-up physician notes are essential.

** This code is for subsequent encounters only. Use W16.211A for the initial encounter and W16.211S for sequelae.Always ensure proper coding to reflect the patient's condition and circumstances of the fall.Accurate coding is essential for proper reimbursement.

  • Payment Status: Active
  • Modifier TC rule: This code does not typically involve a technical component (TC) modifier.
  • Specialties:Emergency Medicine, Family Medicine, Internal Medicine
  • Place of Service:Emergency Room - Hospital, Inpatient Hospital, Office
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