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v1.0.0
ICD-10 Guide
ICD-10 CodesChapter 20: External causes of morbidityV45

V45

Billable

Car occupant injured in collision with railway train or railway vehicle

Chapter 20:External causes of morbidity

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

Code Description

ICD-10 V45 is a billable code used to indicate a diagnosis of car occupant injured in collision with railway train or railway vehicle.

Key Diagnostic Point:

The ICD-10 code V45 is used to classify injuries sustained by car occupants involved in collisions with railway trains or railway vehicles. This code is critical for accurately capturing the circumstances surrounding the injury, which can significantly impact treatment decisions and public health data. Such collisions often result in severe injuries due to the substantial mass and speed of trains compared to automobiles. Common injuries may include traumatic brain injuries, spinal cord injuries, fractures, and internal organ damage. Accurate coding is essential for epidemiological studies, resource allocation, and understanding the impact of such accidents on public health. Documentation should include details about the collision, the type of vehicle involved, and the nature of the injuries sustained to ensure proper coding and billing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for precise documentation of the incident details.
  • Variability in injury severity and types of injuries.
  • Potential for multiple external cause codes to be applicable.
  • Differentiation between types of railway vehicles involved.

Audit Risk Factors

  • Inadequate documentation of the circumstances of the collision.
  • Failure to capture all relevant external cause codes.
  • Misclassification of the type of railway vehicle involved.
  • Inconsistent coding practices among different healthcare providers.

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Emergency departments must document the mechanism of injury, patient presentation, and any pre-hospital care provided.

Common Clinical Scenarios

Patients presenting with trauma after a collision with a train, including head injuries and fractures.

Billing Considerations

Consideration of potential secondary injuries from ejection or secondary impacts.

Trauma Surgery

Documentation Requirements

Detailed operative reports and injury assessments are necessary to capture the full extent of injuries.

Common Clinical Scenarios

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

Billing Considerations

Documentation should reflect the mechanism of injury and any complications arising from the trauma.

Coding Guidelines

Inclusion Criteria

Use V45 When
  • Coders should follow the official ICD
  • CM guidelines for external cause codes, ensuring that the code is used in conjunction with the appropriate injury codes
  • The external cause code should reflect the specific circumstances of the injury

Exclusion Criteria

Do NOT use V45 When
No specific exclusions found.

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used for patients presenting with severe injuries from a train collision.

Documentation Requirements

Detailed documentation of the patient's condition and treatment provided.

Specialty Considerations

Emergency medicine specialists should ensure all aspects of the injury are documented.

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, improving data accuracy and enhancing the ability to track and analyze injury patterns related to railway collisions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of external causes, improving data accuracy and enhancing the ability to track and analyze injury patterns related to railway collisions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of external causes, improving data accuracy and enhancing the ability to track and analyze injury patterns related to railway collisions.

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

When should I use code V45?

Use code V45 when documenting injuries sustained by car occupants involved in a collision with a railway train or vehicle, ensuring that the incident details are well-documented.