Coding for Whiplash Injury in ICD-10

A whiplash injury refers to severe muscle strains in the neck and shoulder region, and is coded as “sprain of ligaments of cervical spine.” It is one of the most common conditions for pain management specialists to treat. The ICD-10 structure offers multiple diagnosis options for coding whiplash injury, but the first-step in reporting should be to specify the affected area of the spine.

ICD-10 Coding Basics

Whiplash injury usually affects the cervical area, but ICD-9 also includes codes for injuries to other spinal areas as well. However, in ICD-10 whiplash coding will come under S13.4xx_ (Sprain of ligaments of cervical spine) under category S13 (Dislocation and sprain of joints and ligaments at neck level). Don’t forget to read the long descriptor before assigning the code.

The code also includes:

  • Sprain of anterior longitudinal ligament cervical
  • Sprain of atlanto-axial (joints)
  • Sprain of atlanto-occipital (joints)
  • Whiplash injury of cervical spine.

Codes in Category S13 Always Require a Seventh Character

Always remember to add the appropriate seventh character to the ICD-10 code for injury, such as

A: Initial encounter:

A seventh character of “A” is used for initial encounters, which the chapter-specific guidelines define as “while the patient is receiving active treatment for the condition”.

D: Subsequent encounter

7th character “D” (subsequent encounter) is used for “encounters after the patient has received active treatment of the condition and is receiving routine care for the condition during the healing or recovery phase.”

S: Sequela.

7th character “S” is used for “complications or conditions that arise as a direct result of a condition, such as scar formation after a burn”.

 What does “code also” refers to in Category S13

The Category S13 has a “code also” note that means one should also code for any associated open wound. Plus, “Code also” is required to fully describe the condition.

In certain cases it may be required to use external cause codes to indicate the circumstances surrounding the injury. For example, V44.5xxA is used to indicate the initial encounter for and injury resulting when a “car driver injured in collision with heavy transport vehicle or bus in traffic accident.”

To learn more about specialty-specific ICD-10 coding training, check our informative ICD-10 Coding Training conferences.

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