2025 ICD-10-CM code W13
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A External causes of morbidity - Falls Chapter 20: External causes of morbidity and mortality Feed
Fall from, out of, or through a building or structure.
Modifiers are not applicable to ICD-10 codes.
Medical necessity is determined by the injuries sustained as a direct result of the fall, and the subsequent treatment required to address those injuries.
The clinical responsibility is to accurately assess and document the injuries sustained as a result of the fall and provide appropriate treatment.
In simple words: This code describes a fall from a building or structure.It's used to record the reason for the injury, not the type of injury that happened.
This ICD-10-CM code classifies falls from, out of, or through a building or structure.It is used to indicate the circumstance of the injury, not the nature of the injury itself.The code should be used secondary to a code from another chapter specifying the injury sustained (e.g., fractures, contusions).
Example 1: A construction worker falls from scaffolding, sustaining a fractured femur and multiple contusions.Codes W13 (fall from building) and S72.00XA (fracture of the femur, initial encounter) would be used., A pedestrian slips on ice and falls from a bridge, suffering a head injury. Codes W13.1 (fall from bridge) and S06.0XXA (head injury, initial encounter) would be assigned., A child falls through a weakened section of the floor in an old building, resulting in a broken wrist. Codes W13.3 (fall through floor) and S52.5XXA (fracture of wrist bones, initial encounter) would be used.
Detailed documentation of the fall, including location, height of fall, circumstances surrounding the incident, and a complete description of all injuries sustained. Radiological reports should support fracture codes if applicable.Witness statements may also be helpful.
** This code should only be used when the fall occurs from a building or structure. Falls from other locations should be coded appropriately.
- Revenue Code: Revenue codes will vary depending on the services rendered and the payer.
- RVU: RVUs are not applicable to ICD-10 codes.
- Global Days: Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.
- Specialties:Emergency Medicine, Orthopedics, Neurosurgery, General Surgery
- Place of Service:Emergency Room - Hospital, Inpatient Hospital, Outpatient Hospital, Office