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v1.0.0
ICD-10 Guide
ICD-10 CodesV05.90

V05.90

Billable

Pedestrian on foot injured in collision with railway train or railway vehicle, unspecified whether traffic or nontraffic accident

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 V05.90 is a billable code used to indicate a diagnosis of pedestrian on foot injured in collision with railway train or railway vehicle, unspecified whether traffic or nontraffic accident.

Key Diagnostic Point:

The ICD-10 code V05.90 is used to classify injuries sustained by pedestrians who are struck by a railway train or railway vehicle. This code is particularly relevant in cases where the circumstances of the accident are unclear, whether it occurred in a traffic context (e.g., at a railway crossing) or in a non-traffic context (e.g., on private property). Injuries can range from minor to severe, including fractures, lacerations, and traumatic brain injuries. Accurate coding is essential for tracking morbidity and mortality associated with such incidents, which can inform public health initiatives and safety regulations. Documentation should include details about the location of the incident, the nature of the injuries, and any contributing factors to the collision, such as visibility conditions or the presence of warning signals. This code is critical for understanding the impact of railway-related accidents on public health and safety.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Ambiguity in determining whether the incident was traffic or nontraffic-related.
  • Variability in documentation quality from different healthcare providers.
  • Need for detailed incident descriptions to support accurate coding.
  • Potential overlap with other external cause codes, requiring careful differentiation.

Audit Risk Factors

  • Inadequate documentation of the circumstances surrounding the accident.
  • Failure to specify whether the incident was traffic or nontraffic-related.
  • Misclassification of injuries due to lack of detail in clinical notes.
  • Inconsistent coding practices among different coders.

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Emergency department notes should clearly document the mechanism of injury, location, and any pre-existing conditions.

Common Clinical Scenarios

Patients presenting with trauma after being struck by a train, including fractures and head injuries.

Billing Considerations

Ensure that all relevant details are captured in the initial assessment to support accurate coding.

Trauma Surgery

Documentation Requirements

Operative reports must detail the nature of injuries and any surgical interventions performed.

Common Clinical Scenarios

Trauma cases involving multiple injuries from a train collision requiring surgical intervention.

Billing Considerations

Consider the potential for multiple external cause codes if other injuries are present.

Coding Guidelines

Inclusion Criteria

Use V05.90 When
  • According to ICD
  • CM coding guidelines, external cause codes should be used in conjunction with the primary diagnosis code
  • It is important to capture the specific circumstances of the injury, including the location and activity at the time of the accident
  • Codes should be sequenced appropriately, with the external cause code following the diagnosis code

Exclusion Criteria

Do NOT use V05.90 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99283CPT Code

Emergency department visit, moderate severity

Clinical Scenario

Used for patients presenting with injuries from a train collision requiring moderate intervention.

Documentation Requirements

Document the nature of the injuries and the treatment provided.

Specialty Considerations

Emergency medicine providers should ensure thorough documentation to support the level of service billed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of external causes of injuries, improving data accuracy and facilitating better public health tracking. V05.90 provides a means to capture pedestrian injuries related to railway incidents, which were less distinctly categorized in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of external causes of injuries, improving data accuracy and facilitating better public health tracking. V05.90 provides a means to capture pedestrian injuries related to railway incidents, which were less distinctly categorized in ICD-9.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What should I document to support the use of V05.90?

Document the specifics of the incident, including the location, whether it was a traffic or nontraffic accident, and the nature of the injuries sustained. This information is crucial for accurate coding and reimbursement.