2025 ICD-10-CM code W18
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A External causes of morbidity - Other slipping, tripping and stumbling and falls Chapter 20: External causes of morbidity and mortality Feed
Other slipping, tripping, stumbling, and falls resulting in injury.
Modifiers may be applicable depending on the specific circumstances of the encounter and the nature of the injury.Consult your local payer's guidelines.
The medical necessity is established by the presence of injuries resulting from the fall requiring medical attention and treatment.The documentation must support the linkage between the fall and the resulting injuries.
The physician's responsibility includes documenting the circumstances of the fall and the resulting injuries.This code documents the cause of the injury, while other codes describe the injury itself.
- Chapter 20: External causes of morbidity and mortality
- V00-Y99 (External causes of morbidity and mortality)
In simple words: This code is for injuries caused by slipping, tripping, or falling, but only when it's not a specific type of fall (like a fall from a building or a fall while riding a bike). The doctor will use a separate code to describe the actual injuries.
This ICD-10-CM code classifies injuries resulting from slipping, tripping, stumbling, or falling, excluding those specifically categorized elsewhere (e.g., falls from a height, falls from a vehicle, or falls due to assault).It's used to report the circumstance of the injury, not the injury itself.The nature of the injury sustained should be coded separately using codes from Chapter 19 (Injury, poisoning and certain other consequences of external causes).
Example 1: A patient falls on a wet floor in a grocery store, sustaining a fractured wrist.W18 would code the circumstances of the fall; a separate code from Chapter 19 would code the wrist fracture., An elderly patient trips on a rug at home, resulting in a concussion. W18 codes the fall while a separate code from Chapter 19 details the concussion., A patient stumbles while walking on uneven terrain, sustaining a sprained ankle. W18 would code the event and a separate code from Chapter 19 would detail the sprained ankle.
Detailed description of the event leading to the fall, including location, contributing factors (e.g., wet floor, uneven surface, obstacles), and the nature and extent of any resulting injuries.Physician's notes, including any diagnostic imaging results, are necessary.
** This code is used for reporting purposes and reimbursement will depend on the specific injury codes used in conjunction with this code.Always verify the appropriateness of the code with your local payer's guidelines.
- Payment Status: Active
- Modifier TC rule: Not applicable to this code.
- Specialties:Emergency Medicine, Orthopedics, Family Medicine, Geriatrics
- Place of Service:Office, Emergency Room - Hospital, Inpatient Hospital, Outpatient Hospital, Other Place of Service