ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesV45.4

V45.4

Billable

Person boarding or alighting a car injured in collision with railway train or railway vehicle

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

Code Description

ICD-10 V45.4 is a billable code used to indicate a diagnosis of person boarding or alighting a car injured in collision with railway train or railway vehicle.

Key Diagnostic Point:

The ICD-10 code V45.4 is used to classify injuries sustained by individuals who are boarding or alighting from a motor vehicle and are subsequently involved in a collision with a railway train or railway vehicle. This code captures the external cause of morbidity and mortality associated with such incidents, which can result in severe injuries or fatalities. The context of this code is critical in understanding the dynamics of accidents involving trains and vehicles, particularly in urban areas where railway crossings are prevalent. Documentation should include details about the circumstances of the incident, including the location, time, and nature of the collision, as well as the type of injuries sustained. Accurate coding is essential for public health data collection, resource allocation, and injury prevention strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Determining the exact circumstances of the injury (boarding vs. alighting)
  • Differentiating between types of vehicles involved (car vs. railway vehicle)
  • Understanding the location specifics (e.g., railway crossing vs. other areas)
  • Documenting the severity of injuries accurately

Audit Risk Factors

  • Inadequate documentation of the incident details
  • Misclassification of the type of vehicle involved
  • Failure to specify whether the individual was boarding or alighting
  • Inconsistent coding practices among different coders

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Emergency department notes should clearly document the mechanism of injury, including the circumstances of boarding or alighting, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with traumatic injuries after being struck by a train while exiting a vehicle at a crossing.

Billing Considerations

Consideration of the patient's mental state and any potential substance use at the time of the incident.

Trauma Surgery

Documentation Requirements

Trauma assessments must include detailed descriptions of injuries, surgical interventions, and the mechanism of injury.

Common Clinical Scenarios

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

Billing Considerations

Documentation should reflect the severity of injuries and any complications arising from the incident.

Coding Guidelines

Inclusion Criteria

Use V45.4 When
  • According to ICD
  • 10 coding guidelines, external cause codes should be used in conjunction with the appropriate injury codes
  • It is essential to capture the external cause of the injury to provide a complete picture for epidemiological studies and resource allocation

Exclusion Criteria

Do NOT use V45.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99284CPT Code

Emergency department visit, high severity

Clinical Scenario

Used when a patient presents to the emergency department with severe injuries from a train collision.

Documentation Requirements

Documentation must reflect the severity of the patient's condition and the complexity of medical decision-making.

Specialty Considerations

Emergency medicine specialists should ensure that all relevant details of the incident are captured.

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 for public health surveillance and injury prevention efforts.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of external causes, improving data accuracy for public health surveillance and injury prevention efforts.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of external causes, improving data accuracy for public health surveillance and injury prevention efforts.

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 V45.4?

Documentation should include the circumstances of the injury, whether the individual was boarding or alighting, the type of vehicle involved, and the nature of the injuries sustained.