2025 ICD-10-CM code Y90
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A External causes of morbidity - Supplementary factors related to causes of morbidity classified elsewhere Chapter 20: External causes of morbidity Feed
Evidence of alcohol involvement determined by blood alcohol level.Code first any associated alcohol-related disorders (F10).
Modifiers do not apply to ICD-10-CM codes.
Medical necessity for the Y90 code is established by the presence of alcohol in the patient's system, as documented by laboratory testing. The code's addition to the claim helps complete the clinical picture and facilitates research, public health surveillance, and possibly risk assessment.
The clinical responsibility lies with the physician or healthcare provider who makes the diagnosis and determines the appropriate primary and secondary codes for the encounter, incorporating the Y90 code where alcohol level is documented in the patient's record as potentially relevant to the diagnosed condition.
- Chapter 20: External causes of morbidity
- Supplementary factors related to causes of morbidity classified elsewhere (Y90-Y99)
In simple words: This code is used when a blood test shows alcohol in the patient's system and this might be related to their health problem.It is added to the main diagnosis code to give extra information about the situation.
This code indicates the presence of alcohol involvement, as determined by a blood alcohol level test. It is used as a secondary code to supplement the primary diagnosis code(s) describing the condition or injury potentially related to alcohol consumption.It should always be used in conjunction with a primary code from another chapter, such as Chapter 19 (Injury, poisoning, and certain other consequences of external causes) or Chapters 1-18, and codes from the F10 category (Mental and Behavioral Disorders due to alcohol use) should be coded first, if applicable.The code does not specify the level of alcohol involvement or its direct causal relationship to the primary diagnosis; it simply documents its presence.
Example 1: A patient presents to the emergency department following a motor vehicle accident.Blood alcohol level testing reveals a positive result.The primary diagnosis might be a fracture (S00-S99), with Y90 added as a secondary code to indicate the presence of alcohol. , A patient is admitted to the hospital with acute pancreatitis.The patient's blood alcohol level is elevated.The primary diagnosis would be the pancreatitis (K85), with Y90 used as a secondary code. , A patient presents to the clinic with acute alcohol intoxication and an associated injury, like a laceration.The primary diagnosis would be the intoxication (F10.90), followed by codes for the laceration (e.g., S00-S99) and the secondary code Y90.
Documentation should include the blood alcohol concentration (BAC) level, the method used to obtain the BAC level, and the time the blood sample was obtained.The medical record should also clearly state the relationship (or lack thereof) between the BAC and the primary diagnosis.
** This code should only be used when the alcohol level is determined by a formal test (e.g., blood alcohol content testing).Clinical judgment is required to determine if a causal relationship exists between the alcohol involvement and the patient's condition.It is not appropriate to use this code if alcohol is simply mentioned in the record without supporting laboratory evidence.
- Revenue Code: Revenue codes will vary depending on the specific services provided and the payer.Consult your payer's guidelines for appropriate revenue codes.
- RVU: RVUs are not applicable to ICD-10 codes.RVUs are associated with CPT and HCPCS codes, which represent procedures and services.
- Global Days: Not applicable to ICD-10 codes. Global days are relevant to surgical procedures coded with CPT codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10-CM codes.
- Fee Schedule: Not applicable to ICD-10-CM codes.
- Specialties:Emergency Medicine, Internal Medicine, Surgery, Toxicology
- Place of Service:The place of service is dependent on where the patient receives care (e.g., Emergency Room - Hospital, Inpatient Hospital, Office, etc.).