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v1.0.0
ICD-10 Guide
ICD-10 CodesV11.1

V11.1

Billable

Pedal cycle passenger injured in collision with other pedal cycle in nontraffic accident

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

Code Description

ICD-10 V11.1 is a billable code used to indicate a diagnosis of pedal cycle passenger injured in collision with other pedal cycle in nontraffic accident.

Key Diagnostic Point:

The ICD-10 code V11.1 is used to classify injuries sustained by a passenger on a pedal cycle who is involved in a collision with another pedal cycle in a nontraffic setting. This code is particularly relevant in scenarios where individuals are riding bicycles in parks, on private property, or in other non-public road environments. The injuries can range from minor abrasions and contusions to more severe trauma such as fractures or head injuries. Accurate coding is essential for tracking the incidence of such injuries, which can inform public health initiatives aimed at improving safety for cyclists. Documentation should include details about the nature of the collision, the environment in which it occurred, and the specific injuries sustained to ensure proper coding and billing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Determining the exact nature of the accident (nontraffic vs. traffic)
  • Differentiating between types of injuries sustained
  • Understanding the context of the collision (e.g., location, circumstances)
  • Ensuring accurate documentation of passenger status versus operator status

Audit Risk Factors

  • Inadequate documentation of the accident circumstances
  • Misclassification of the accident type (traffic vs. nontraffic)
  • Failure to specify the role of the individual (passenger vs. cyclist)
  • Inconsistent coding practices across different healthcare settings

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Emergency departments must document the mechanism of injury, location of the incident, and specific injuries sustained. Detailed notes on the patient's condition upon arrival and any immediate interventions are crucial.

Common Clinical Scenarios

Common scenarios include a cyclist being struck by another cyclist in a park or during a recreational event, leading to various injuries.

Billing Considerations

Emergency physicians should ensure that the passenger's role is clearly documented to avoid confusion with operator codes.

Trauma Surgery

Documentation Requirements

Trauma documentation should include a comprehensive assessment of injuries, surgical interventions, and follow-up care plans. The mechanism of injury must be clearly articulated.

Common Clinical Scenarios

Trauma surgeons may encounter cases where a passenger sustains significant injuries from a collision, necessitating surgical intervention.

Billing Considerations

Trauma coding must accurately reflect the nature of the injuries and the circumstances of the accident to ensure appropriate reimbursement and data collection.

Coding Guidelines

Inclusion Criteria

Use V11.1 When
  • According to ICD
  • 10 coding guidelines, external cause codes should be used in conjunction with the primary diagnosis code
  • It is essential to capture the full context of the incident, including the location and circumstances, to ensure accurate coding

Exclusion Criteria

Do NOT use V11.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99283CPT Code

Emergency department visit, moderate severity

Clinical Scenario

Used when a patient presents to the emergency department with injuries from a pedal cycle collision.

Documentation Requirements

Documentation must include the patient's presenting complaints, examination findings, and any treatments provided.

Specialty Considerations

Emergency medicine specialists should ensure that the mechanism of injury is clearly 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 of injuries, including nontraffic pedal cycle accidents. This specificity aids in better tracking and understanding of injury patterns.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of external causes of injuries, including nontraffic pedal cycle accidents. This specificity aids in better tracking and understanding of injury patterns.

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 use code V11.1?

Documentation should include the specifics of the accident, the role of the individual (passenger), the location of the incident, and detailed descriptions of the injuries sustained.