Coding Tip: Coding for Healthcare Encounters in Hurricane Aftermath

This Coding Tip was updated on 8/12/2022
With the Hurricane season in full swing, this guideline will be helpful in reporting the external cause codes when an injury occurs as a result of the hurricane, and also help in determining sequencing of the reported codes.


New ICD-10-CM Codes for FY2019 to Report Hurricane

  • X37.0XXA—Hurricane, initial encounter
  • X37.0XXD—Hurricane, subsequent encounter
  • X37.0XXS—Hurricane, sequela

Use of External Cause of Morbidity Codes:

  • Never reported as the principal diagnosis or first-listed code and are supplemental codes only
  • Capture how the injury or condition happened—REMEMBER: IPAS (injury how it occurred; place of occurrence; activity of patient at time of injury; status of the patient)
  • May be assigned in all health care settings
  • A healthcare setting is considered any location where medical care is provided by licensed healthcare professionals.

Sequencing of External Causes of Morbidity Codes:

  • When cataclysmic events occur (such as hurricane) these codes take priority over all other external cause (except child abuse, adult abuse, and terrorism)
  • Assign as many external cause of morbidity codes as needed to fully explain the circumstances of the injury/condition

If it is not clearly documented that the injury/condition is a direct result of the hurricane, the coder should assume the injury/condition is due to the hurricane and report X37.0-. If the injury is not a direct result of the hurricane do not assign X37.0-. What this means is that injuries/conditions may arise during a hurricane that are not related to the actual hurricane (such as a MVC or animal bite).

ICD-10-CM Official Guidelines for Coding and Reporting FY2019; Page 19-21
AHA Coding Clinic for ICD-10-CM/PCS, Fourth Quarter 2018: Page 57

The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.

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