Halloween brings fun, fright—and a rise in emergency and urgent care visits. From pumpkin-carving cuts to hot glue burns, seasonal injuries can present coding challenges when documentation lacks detail. This guide outlines common Halloween-related encounters and provides ICD-10-CM coding examples, documentation tips, and query reminders to help ensure every case is coded accurately and compliantly.
Pumpkins, costumes, and candy make Halloween fun—but also prime time for injuries. Every October, there is a spike in emergency and urgent care encounters for lacerations, burns, falls, and allergic reactions. Coders and auditors need to be ready to accurately assign ICD-10-CM codes, including applying correct seventh characters, and capturing external cause details when available. This mini-guide highlights the most common Halloween-related injuries and how to ensure documentation supports accurate code assignment.
Common Scenarios: Pumpkin carving accidents, broken glass injuries, knife slips.
Documentation Should Include:
Examples:
🎃 Coding Tip: If repair was performed, verify documentation supports simple, intermediate, or complex repair for accurate CPT reporting and future audit defense.
Common Scenarios: Contact with open flame, hot glue, or wax.
Documentation Should Include:
Examples:
🎃 Coding Tip: When multiple burns occur, sequence the highest-degree burn first, and don’t forget the external cause code describing how it happened.
Common Scenarios: Trips on costumes, falls on/from steps or porches.
Documentation Should Include:
Examples:
🎃 Coding Tip: External cause codes (V00–Y99) aren’t always required for billing, but they’re valuable for injury surveillance and quality reporting—and they tell the story behind the injury.
Common Scenarios: Corneal abrasions, allergic reactions
Documentation Should Include:
Examples:
🎃 Coding Tip: Injuries require assignment of a 7th character based on the nature of the encounter.
Common Scenarios: Food allergies, exposure to chemicals
Documentation Should Include:
Examples:
🎃 Coding Tip: Be cautious when the record lacks clarity on severity—query when uncertain between mild reaction, urticaria, or true anaphylaxis.
Common Scenarios: Trick-or-treaters hit by vehicles, bicycle falls, scooter accidents.
Documentation Should Include:
Examples:
🎃 Coding Tip: Combine injury codes with external cause, place of occurrence, and activity codes to give a full picture of the event.
| Situation | Example | Category & Code |
| Correct drug, correct dose, side effect | Nausea after prescribed codeine | T40.2X5A – Adverse effect of other opioids |
| Wrong substance or dose of drugs | Child ingests parent’s medication | T40.2X1A – Poisoning by other opioids, accidental |
| Harmful, non-medicinal substance | Chemical burn from makeup remover | T54.3X1A – Toxic effect of corrosive alkalis and alkali-like substances, accidental |
🎃 Coding Tip: If a reaction is caused by a prescribed medication taken correctly, it’s an adverse effect—not poisoning. Misuse or wrong dose of drugs changes the code.
🎃 Coding Tip: Always verify that the seventh character (A, D, or S) identifying type of encounter is applied consistently across all related codes.
Halloween injuries may be temporary, but documentation quality has long-term effects on coding accuracy, audit readiness, and quality data. Encourage providers to describe who, where, how, and what happened in every injury note—and coders to leverage external cause codes when applicable.
For more than 30 years, HIA has been the leading provider of compliance audits, coding support services and clinical documentation audit services for hospitals, ambulatory surgery centers, physician groups and other healthcare entities. HIA offers PRN support as well as total outsource support.
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.