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ICD-10 Guide
ICD-10 CodesV13.5

V13.5

Billable

Pedal cycle passenger injured in collision with car, pick-up truck or van in traffic accident

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

Code Description

ICD-10 V13.5 is a billable code used to indicate a diagnosis of pedal cycle passenger injured in collision with car, pick-up truck or van in traffic accident.

Key Diagnostic Point:

The ICD-10 code V13.5 is used to classify injuries sustained by a pedal cycle passenger involved in a collision with a motor vehicle, specifically a car, pick-up truck, or van, during a traffic accident. This code is essential for capturing the external cause of morbidity and mortality related to traffic incidents involving cyclists. In clinical practice, this code is typically applied when a patient presents with injuries resulting from such an accident, which may include fractures, contusions, or lacerations. Accurate coding is crucial for public health data collection, resource allocation, and injury prevention strategies. It is important to document the circumstances of the accident, including the type of vehicle involved and the location of the incident, to ensure precise coding and facilitate effective treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for detailed documentation of the accident circumstances
  • Differentiation between passenger and cyclist roles
  • Potential for multiple injuries requiring additional codes
  • Variability in state laws regarding cyclist rights and responsibilities

Audit Risk Factors

  • Inadequate documentation of the accident details
  • Misclassification of the patient as a cyclist instead of a passenger
  • Failure to capture all injuries sustained in the accident
  • Inconsistent coding practices across different healthcare providers

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Emergency department notes should include a detailed account of the accident, including the type of vehicle involved, the location, and the mechanism of injury.

Common Clinical Scenarios

Patients presenting with fractures, head injuries, or soft tissue injuries following a collision while riding as a passenger on a bicycle.

Billing Considerations

Ensure that the role of the patient (passenger vs. cyclist) is clearly documented to avoid coding errors.

Trauma Surgery

Documentation Requirements

Trauma registries require comprehensive documentation of the mechanism of injury, including vehicle type and impact details.

Common Clinical Scenarios

Trauma cases involving multiple injuries from a traffic accident, necessitating surgical intervention.

Billing Considerations

Consider the potential for co-existing injuries that may require additional coding.

Coding Guidelines

Inclusion Criteria

Use V13.5 When
  • According to ICD
  • 10 coding guidelines, external cause codes should be used in conjunction with the appropriate injury codes
  • The external cause code should be reported in the secondary position, following the primary diagnosis code for the injury sustained

Exclusion Criteria

Do NOT use V13.5 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 injuries from a traffic accident.

Documentation Requirements

Document the nature of the injuries, the mechanism of injury, and any treatments provided.

Specialty Considerations

Emergency medicine specialists should ensure thorough documentation to support the level of service billed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more granular coding of external causes of injuries, improving data accuracy for public health initiatives and injury prevention strategies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more granular coding of external causes of injuries, improving data accuracy for public health initiatives and injury prevention strategies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more granular coding of external causes of injuries, improving data accuracy for public health initiatives and injury prevention strategies.

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 V13.5?

Documentation should include details of the accident, such as the type of vehicle involved, the patient's role (passenger), and the nature of the injuries sustained.