Coding for Healthcare Encounters in Hurricane Aftermath

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).

Authored by Kim Boy, RHIT, CDIP, CCS, CCS-P

References:
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