2025 ICD-10-CM code W16.211
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A External causes of morbidity - Falls Chapter 20: External causes of morbidity Feed
Fall in a filled bathtub resulting in drowning and submersion.
Modifiers may be applicable depending on the circumstances of the event and any additional procedures performed.Consult the current coding guidelines and payer-specific rules to determine appropriate modifier use.
The medical necessity is established by the occurrence of the fall resulting in drowning and submersion.The documentation must support the causal link between the fall and the death.
The clinical responsibility would involve assessing the patient's injuries and determining the cause of death.If the patient survives, treatment would address any resulting injuries.In cases of death, a thorough investigation may be necessary to confirm the cause of death and record it accurately.
- Chapter 20: External causes of morbidity
- W16.211 is under the broader category of W16.2 (Fall in (into) filled bathtub or bucket of water), which itself falls under W16 (Fall, jump or diving into water), belonging to the chapter V00-Y99 (External causes of morbidity).
In simple words: This code is used when someone falls in a bathtub full of water and drowns. It's important to note that this is different from drowning in a full bathtub without falling.
This code classifies a fall into a filled bathtub that directly leads to drowning and submersion.It is crucial to differentiate this from drowning in a filled bathtub without a preceding fall (W65), which would require a different code.The seventh character (A, D, or S) should be added to specify the encounter status: A for initial encounter, D for subsequent encounter, and S for sequela.
Example 1: A 70-year-old female with a history of syncope falls into a filled bathtub, resulting in drowning. Code W16.211A is assigned., An 8-year-old child slips and falls into a filled bathtub, causing drowning and subsequent death. Code W16.211A is used for the initial encounter, followed by code W16.211S if there are sequelae after the immediate event., A 55-year-old male experiences a seizure while bathing, leading to a fall into the bathtub, causing drowning and submersion. Code W16.211A, accompanied by codes indicating the seizure as the underlying cause, would be used.This illustrates the need for additional codes, as this chapter (external causes of morbidity) is typically used secondarily to codes in Chapter 19.
Detailed documentation should include the circumstances of the fall, the presence or absence of witnesses, the patient's medical history (particularly conditions that might predispose to falls such as syncope), the time elapsed between the fall and the discovery, the resuscitation attempts (if any), and the cause of death.A complete autopsy report is required if applicable.
** Accurate coding requires meticulous documentation of the circumstances leading to the fall and the subsequent drowning.The use of additional codes from Chapter 19 is frequently necessary to reflect the full clinical picture.This code should only be used when drowning directly results from the fall into the filled bathtub.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Emergency Medicine, Forensic Pathology, Internal Medicine
- Place of Service:Home, Inpatient Hospital