2025 ICD-10-CM code Y92.1
(Active) Effective Date: N/A External causes of morbidity - Supplementary factors related to causes of morbidity classified elsewhere 20 Feed
This code identifies an institutional (non-private) residence as the place where an external cause of morbidity occurred.
The medical necessity of using Y92.1 is to provide additional information about the circumstances surrounding the injury or illness. This helps in tracking and analyzing data related to external causes of morbidity in different settings.
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- External causes of morbidity (V00-Y99)Supplementary factors related to causes of morbidity classified elsewhere (Y90-Y99)Place of occurrence of the external cause (Y92)
In simple words: This code indicates that the cause of injury or illness happened in a place like a group home, nursing home, or other similar facility.
Institutional (nonprivate) residence as the place of occurrence of the external cause.This code is used to indicate that the place where the external cause of injury or illness occurred was a non-private institutional residence. This code is not intended to be used for single-condition coding but rather as a supplementary code providing additional information about the cause of the condition.
Example 1: A patient falls and breaks their hip while residing in a nursing home. The fall is the primary diagnosis, and Y92.1 is used to specify the location of the incident., A patient in a rehabilitation center develops a pressure ulcer. The pressure ulcer is the primary diagnosis, and Y92.1 is used to indicate that the injury occurred while the patient was a resident of the facility., A patient contracts influenza at their assisted living facility. The primary diagnosis is influenza and the code Y92.1 is used to show the location of the cause as assisted living.
Documentation should clearly state the location of the incident/event causing the injury or illness and that the location was an institutional (non-private) residence.
** Excludes: building under construction (Y92.6), residential institution as place of occurrence (Y92.1)
- Place of Service:Nursing Facility, Skilled Nursing Facility, Assisted Living Facility, Inpatient Hospital,Custodial Care Facility, Hospice