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ICD-10 Guide
ICD-10 CodesV04.1

V04.1

Billable

Pedestrian injured in collision with heavy transport vehicle or bus in traffic accident

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

Code Description

ICD-10 V04.1 is a billable code used to indicate a diagnosis of pedestrian injured in collision with heavy transport vehicle or bus in traffic accident.

Key Diagnostic Point:

The ICD-10 code V04.1 is used to classify injuries sustained by pedestrians involved in collisions with heavy transport vehicles or buses during traffic accidents. This code is crucial for capturing the external causes of morbidity and mortality related to traffic incidents, particularly those involving larger vehicles that can cause significant harm due to their size and weight. Clinical scenarios may include a pedestrian struck by a bus at a crosswalk or a heavy truck while attempting to cross a busy street. Accurate coding of such incidents is essential for public health data collection, injury prevention strategies, and resource allocation for emergency services. Documentation should include details about the circumstances of the accident, the type of vehicle involved, and the nature of the injuries sustained to ensure proper coding and analysis of traffic-related injuries.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for precise documentation of the accident circumstances
  • Differentiation between types of vehicles involved
  • Potential for multiple injuries requiring additional codes
  • Variability in local traffic laws affecting documentation

Audit Risk Factors

  • Inadequate documentation of the accident details
  • Misclassification of the type of vehicle involved
  • Failure to capture all injuries sustained
  • Inconsistent coding practices among different coders

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Emergency department notes should clearly document the mechanism of injury, type of vehicle, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with fractures, lacerations, or traumatic brain injuries after being struck by a bus or truck.

Billing Considerations

Consideration of potential secondary injuries from falls or other impacts during the accident.

Trauma Surgery

Documentation Requirements

Trauma assessments must include detailed descriptions of injuries, surgical interventions, and follow-up care.

Common Clinical Scenarios

Severe injuries requiring surgical intervention, such as pelvic fractures or internal organ damage.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use V04.1 When
  • According to ICD
  • 10 coding guidelines, external cause codes should be used in conjunction with the appropriate injury codes
  • It is essential to report the external cause code to provide context for the injury and to follow the guidelines for sequencing codes correctly

Exclusion Criteria

Do NOT use V04.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99284CPT Code

Emergency department visit, high severity

Clinical Scenario

Used when a pedestrian presents to the ED with severe injuries after being struck by a heavy vehicle.

Documentation Requirements

Documentation must include the patient's presenting symptoms, examination findings, and treatment provided.

Specialty Considerations

Emergency medicine specialists should ensure that all relevant injuries are documented 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, improving data accuracy for public health initiatives and injury prevention strategies. V04.1 provides a clear classification for pedestrian injuries involving heavy vehicles, which was less detailed in ICD-9.

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 initiatives and injury prevention strategies. V04.1 provides a clear classification for pedestrian injuries involving heavy vehicles, which was less detailed in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of external causes, improving data accuracy for public health initiatives and injury prevention strategies. V04.1 provides a clear classification for pedestrian injuries involving heavy vehicles, which was less detailed in ICD-9.

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 types of injuries are typically associated with V04.1?

Injuries associated with V04.1 can include fractures, contusions, lacerations, and traumatic brain injuries, often resulting from the significant force of impact with heavy vehicles.