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v1.0.0
ICD-10 Guide
ICD-10 CodesV12.3

V12.3

Billable

Person boarding or alighting a pedal cycle injured in collision with two- or three-wheeled motor vehicle

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

Code Description

ICD-10 V12.3 is a billable code used to indicate a diagnosis of person boarding or alighting a pedal cycle injured in collision with two- or three-wheeled motor vehicle.

Key Diagnostic Point:

This code is used to classify injuries sustained by individuals who are boarding or disembarking from a pedal cycle and are involved in a collision with a two- or three-wheeled motor vehicle. Such incidents often occur in urban environments where cyclists share the road with motor vehicles. The injuries can range from minor abrasions and contusions to severe trauma, including fractures and head injuries. Accurate coding is essential for tracking the incidence of cycling-related injuries, which can inform public health initiatives aimed at improving road safety for cyclists. Documentation should include details about the circumstances of the incident, the type of vehicle involved, and the nature of the injuries sustained. This code is particularly relevant in the context of increasing cycling popularity and the need for enhanced safety measures for cyclists.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Determining the exact circumstances of the incident can be challenging.
  • Differentiating between types of motor vehicles involved.
  • Accurate documentation of the patient's actions (boarding or alighting).
  • Potential for multiple external cause codes to apply.

Audit Risk Factors

  • Inadequate documentation of the incident details.
  • Misclassification of the type of vehicle involved.
  • Failure to capture the cyclist's actions leading to the injury.
  • Inconsistent coding practices among different healthcare providers.

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Emergency department notes should clearly describe the mechanism of injury, including the cyclist's actions and the type of motor vehicle involved.

Common Clinical Scenarios

Patients presenting with fractures, lacerations, or head injuries after a collision with a motorcycle or scooter.

Billing Considerations

Consider the need for additional codes to capture specific injuries sustained during the incident.

Trauma Surgery

Documentation Requirements

Detailed operative reports and trauma assessments should include the mechanism of injury and any surgical interventions performed.

Common Clinical Scenarios

Severe injuries requiring surgical intervention, such as pelvic fractures or traumatic brain injuries.

Billing Considerations

Ensure that all injuries are documented and coded accurately to reflect the full extent of trauma.

Coding Guidelines

Inclusion Criteria

Use V12.3 When
  • Follow the ICD
  • CM coding guidelines for external causes of morbidity
  • Ensure that the code is used in conjunction with the appropriate injury codes to provide a complete picture of the patient's condition

Exclusion Criteria

Do NOT use V12.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99283CPT Code

Emergency department visit, level 3

Clinical Scenario

Used when a patient presents to the emergency department with injuries from a cycling accident.

Documentation Requirements

Document the nature of the injuries and the circumstances of the accident.

Specialty Considerations

Emergency medicine providers should ensure that all relevant details are captured for accurate coding.

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, including those related to cycling. This specificity aids in better tracking and analysis of injury patterns, which can inform public health initiatives.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of external causes of injuries, including those related to cycling. This specificity aids in better tracking and analysis of injury patterns, which can inform public health initiatives.

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 be documented to support the use of code V12.3?

Documentation should include the circumstances of the incident, the type of motor vehicle involved, the actions of the cyclist (boarding or alighting), and the nature of the injuries sustained.