Use of hurricane-related ICD-10 codes is changing

This year’s ICD-10 diagnosis code updates are just around the corner.

Among the changes is a subject that has received a lot of attention in recent weeks and may involve some of your patients, especially if you practice in the Carolinas or the Philippines: hurricane-related encounters.

The external cause codes for hurricane-related encounters (X37.0-) have existed since ICD-10 was adopted. The important change, beginning Oct. 1, is that the National Center for Health Statistics provided clear definition on how to apply the codes correctly.

These are external cause codes, so do not list them as the primary diagnosis. Code the injury first, then the correct X37.0- code. Hurricane external cause codes assume priority over all other external cause codes except for child/adult abuse and terrorism. For example, if a patient is seen for injuries sustained when hurricane damage directly caused a building to collapse, then the appropriate order of diagnoses would be:

1. Injury (of any nature),
2. X37.0XXA (Hurricane),
3. W20.1XXA (Struck by object due to collapse of a building).

On the other hand, if a patient is evaluated for an injury not related to the hurricane – for example, a vehicle accident while trying to evacuate ahead of the storm – you should not assign X37.0-. If it is not apparent if the injury was directly due to the hurricane, proceed with attaching X37.0- to the encounter.

External cause codes are extensive and have their own subsection of the ICD-10 Index. They can be found in chapter 20 of the ICD-10 (V00-Y99.) They may not directly affect payment based on the insurance carrier. However, using them allows you to tell the patient’s story (and yours) in a more accurate manner.

– Barbara Hays, CPC, CPMA, CPC-I, CEMC, Coding and Compliance Strategist for the American Academy of Family Physicians