Home for the Holidays Means More In-Home Injuries. Are You Code-Ready?

December 18, 2023

According to the Consumer Product Safety Commission, during the 2022 holiday season, nearly 15,000 Americans received medical treatment for decorating-related injuries—about 160 per day. Four in 10 of those injuries resulted from falls. The Electrical Safety Foundation reports that around 2,000 people every year require medical treatment for sprains, lacerations, contusions, and fractures after tripping over extension cords, which are heavily used to light holiday trees and outdoor lights.

Given the likelihood that you’ll see patients in the coming weeks with injuries related to holiday-related accidents, here’s a refresher on some codes you’re more likely to use during this season (including a few you’ll probably never use at any OTHER time of year). And remember: Code for the whole picture by including the accident and location codes that payors require for timely reimbursement!

Electrocution, initial encounter – T75.4XXA

Each year, approximately 1,000 people are electrocuted while decorating their Christmas trees. We hope none of your patients are among them. But if they are, you may need this code: W86.0XXA-Exposure to domestic wiring and appliances.

Falls while hanging decorations

How do you code this type of injury? It depends on where it happened. If the patient fell while standing on a ladder, then the proper code for the initial encounter is W11.XXXA. If the patient was actually standing on one of the branches of a tree while hanging outdoor lights or decorations, then the applicable code is W14.XXXA-Fall from tree, initial encounter.

Burn by candle – X08.8

As the nights of Hanukkah progress, you’re more likely to see this one.

Contact with edge of stiff paper, initial encounter – W26.2XXA

Holiday gift-wrapping increases the likelihood of paper cuts. Most aren’t severe enough to require a doctor’s attention, but sometimes complicating conditions lead to an office visit.

Cooking injury – Y93.G

With so many people cooking for holiday meals, it’s not surprising that we see more cooking-related injuries. Did you know the number of cooking fires spikes to more than three times the daily average on Thanksgiving Day? More food preparation means more opportunities for accidental knife cuts and burns from hot pans. If the diagnosis is an injury sustained while preparing food, this is the non-billable code you must include. PS: Naturally, there is a code for conditions related to the results of cooking: R12-Heartburn.

Fall from a reindeer-pulled sleigh? V80.929A

If your patient was dashing through the snow, in a one-horse open sleigh, and then fell out and dashed her head, be sure to apply this code for Occupant of animal-drawn vehicle injured in an unspecified transport accident, initial encounter. If your patient fell out of the sleigh as the result of a collision with another animal, there is (of course) a separate external code for that: V80.1.

And finally:

In the unlikely event that Grandma gets run over by a reindeer, here’s the specific ICD-10 code you’ll need to use: V06.00XA-Collision with nonmotor vehicle, or W55.32XA-Struck by other hoof stock, initial encounter. By the way, in the Small World Department, one of the members of our Calm Waters AI team is friends with the composer of “Grandma Got Run over by a Reindeer.” The writer, Randy Brooks, says he earned so much in royalties from his unexpected hit (songwriting wasn’t even his day job) that “Grandma” put both his children through college.

Happy Holidays from our Calm Waters AI and Coffee & Coding family to yours!


Got a question about E/M coding? We’d love to hear from you.

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Michelle Sergei-Casiano
Michelle Sergei-Casiano
Michelle Sergei-Casiano
CPC, CFPC, CEMC Senior Manager, Regulatory and Coding Compliance coders@calmwatersai.com