2025 ICD-10-CM code Y92.194
Driveway of other specified residential institution as the place of occurrence of the external cause.
Not applicable
Medical necessity must be established for the underlying condition or injury. Y92.194 serves as supplementary information to add context to the event, but it doesn’t establish medical necessity on its own. The primary diagnosis code will drive the medical necessity.
- 20. External causes of morbidity (V00-Y99)
- External causes of morbidity (V01-Y99)Supplementary factors related to causes of morbidity classified elsewhere (Y90-Y99)Place of occurrence of the external cause
In simple words: This code indicates that the injury or illness happened on the driveway of a residential institution like a nursing home or group home (but not a prison or military base).
Driveway of other specified residential institution as the place of occurrence of the external cause. This code is used to indicate that the place where the external cause of morbidity occurred was the driveway of a residential institution other than a prison/jail or military base.It’s important to remember that this code is not meant to be used alone. It must be used in conjunction with another code that describes the nature of the condition. For example, a fall occurring on the driveway might be reported with a code for a fracture (from Chapter 19) along with Y92.194.
Example 1: A patient residing in a nursing home fell on the driveway while being escorted to a vehicle. The patient sustained a Colles' fracture. The codes used would be S52.501A (Colles' fracture, right wrist, initial encounter for closed fracture), W01.0XXA (Fall on same level from slipping, tripping, and stumbling with subsequent striking against inanimate object, initial encounter), and Y92.194., A resident of an assisted living facility was struck by a car while in the driveway of the facility. The patient sustained a head injury. The codes would include codes for the specific injury, a code for being struck by a motor vehicle, and Y92.194., A staff member of a group home tripped and fell on the facility's driveway while taking out the trash, resulting in a sprained ankle. The coder would report the appropriate code for the sprain along with W17.4XXA (Unspecified fall involving wheelbarrow, cart, or other nonpowered hand transport, initial encounter) and Y92.194.
Documentation should clearly indicate the location of the event as the driveway of the residential institution. The documentation should also support the diagnosis and medical necessity of the services provided. Additionally, the nature of the injury or illness should be clearly documented, including the cause, the affected body part, and the severity.
** “Other specified residential institutions” refers to any residential institution setting other than a private residence (Y92.0), a school/educational institution (Y92.2), prison (Y92.14), or military base (Y92.13). The specific type of residential institution, if known, should be documented.As of today, December 2nd, 2024, this information is current. Please be aware that coding guidelines and regulations are subject to change.
- Modifier TC rule: Not applicable
- Specialties:Any specialty treating injuries or illnesses occurring at the specified location can use this code, including, but not limited to: Emergency Medicine, Internal Medicine, Family Medicine, Orthopedics, or General Surgery. Coders in these specialties would also use this code.
- Place of Service:Assisted Living Facility, Group Home, Skilled Nursing Facility, Nursing Facility, Custodial Care Facility, Inpatient Hospital (if admitted after the injury), or Emergency Room - Hospital.