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ICD-10 Guide
ICD-10 CodesV49.69

V49.69

Billable

Unspecified car occupant injured in collision with other motor vehicles in traffic accident

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

Code Description

ICD-10 V49.69 is a billable code used to indicate a diagnosis of unspecified car occupant injured in collision with other motor vehicles in traffic accident.

Key Diagnostic Point:

The ICD-10 code V49.69 is used to classify injuries sustained by an unspecified car occupant involved in a collision with other motor vehicles during a traffic accident. This code is particularly relevant when the specifics of the injury or the role of the occupant (e.g., driver, passenger) are not clearly documented. It encompasses a wide range of potential injuries, from minor bruises to severe trauma, and is crucial for understanding the epidemiology of traffic-related injuries. Accurate coding is essential for public health data collection, resource allocation, and injury prevention strategies. This code is often utilized in emergency departments, trauma centers, and outpatient settings where initial assessments may lack detailed information about the circumstances of the injury. Proper documentation is vital to ensure that the code reflects the patient's condition accurately and supports appropriate treatment and billing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity in documentation regarding the nature of the injury.
  • Variability in how injuries are reported by different healthcare providers.
  • Potential for misclassification if the role of the occupant is not clearly defined.
  • Need for additional codes to capture the full extent of injuries or complications.

Audit Risk Factors

  • Inadequate documentation of the circumstances surrounding the injury.
  • Failure to specify the role of the occupant (driver vs. passenger).
  • Inconsistent coding practices among different providers.
  • Use of this code without supporting clinical evidence.

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Emergency departments must document the mechanism of injury, the patient's role in the vehicle, and any immediate treatment provided.

Common Clinical Scenarios

Patients presenting with injuries from a traffic accident, where the specifics of the injury are not fully known at the time of initial assessment.

Billing Considerations

Emergency providers should ensure that all relevant details are captured in the medical record to support accurate coding.

Trauma Surgery

Documentation Requirements

Trauma surgeons need detailed documentation of the injury types, treatment provided, and any complications that arise.

Common Clinical Scenarios

Trauma cases involving multiple injuries from a traffic accident, where the initial coding may need to be refined as more information becomes available.

Billing Considerations

Trauma documentation should include specifics about the injury mechanism and any surgical interventions performed.

Coding Guidelines

Inclusion Criteria

Use V49.69 When
  • According to ICD
  • 10 coding guidelines, external cause codes should be used in conjunction with the appropriate injury codes
  • It is essential to document the circumstances of the injury, including the location, activity at the time of the accident, and the role of the occupant
  • These codes should be reported in the secondary position after the primary diagnosis code

Exclusion Criteria

Do NOT use V49.69 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 traffic accident requiring moderate medical decision-making.

Documentation Requirements

Documentation must support the level of service, including history, examination, and medical decision-making.

Specialty Considerations

Emergency medicine providers should ensure that the visit is well-documented to justify the CPT code.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of external causes of injuries, including traffic accidents. However, the unspecified nature of V49.69 can lead to challenges in data analysis and resource allocation if not used judiciously.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of external causes of injuries, including traffic accidents. However, the unspecified nature of V49.69 can lead to challenges in data analysis and resource allocation if not used judiciously.

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

When should I use V49.69?

Use V49.69 when a car occupant is injured in a collision with other motor vehicles, and the specifics of the injury or the occupant's role are not documented. Ensure that this code is supported by the clinical documentation.