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ICD-10 Guide
ICD-10 CodesV42.6

V42.6

Billable

Car passenger injured in collision with two- or three-wheeled motor vehicle in traffic accident

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

Code Description

ICD-10 V42.6 is a billable code used to indicate a diagnosis of car passenger injured in collision with two- or three-wheeled motor vehicle in traffic accident.

Key Diagnostic Point:

The ICD-10 code V42.6 is used to classify injuries sustained by a car passenger involved in a traffic accident where a two- or three-wheeled motor vehicle is involved. This code is essential for capturing the external cause of morbidity and mortality related to traffic accidents, specifically highlighting the dynamics of collisions involving different types of vehicles. In clinical practice, this code is often applied in emergency departments and trauma centers where patients present with injuries resulting from such accidents. Documentation must include details about the nature of the collision, the type of vehicles involved, and the specific injuries sustained by the passenger. Accurate coding is crucial for public health data, insurance claims, and resource allocation in trauma care. This code helps in understanding the epidemiology of traffic-related injuries and informs preventive measures and policy-making.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of vehicles involved in the accident.
  • Documenting the specific injuries sustained by the passenger.
  • Understanding the context of the accident (e.g., urban vs. rural setting).
  • Ensuring accurate linkage with primary diagnosis codes for injuries.

Audit Risk Factors

  • Inadequate documentation of the accident details.
  • Failure to specify the type of injuries sustained.
  • Incorrect linkage with primary diagnosis codes.
  • Misclassification of the type of vehicle involved.

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Emergency departments must document the mechanism of injury, type of vehicles involved, and specific injuries to support the use of V42.6.

Common Clinical Scenarios

A passenger in a car suffers a fracture after a collision with a motorcycle.

Billing Considerations

Emergency physicians should ensure that the narrative of the accident is clear and detailed to support accurate coding.

Trauma Surgery

Documentation Requirements

Trauma surgeons need to document the extent of injuries and the mechanism of injury in detail to justify the use of this code.

Common Clinical Scenarios

A passenger requires surgical intervention after being injured in a collision with a scooter.

Billing Considerations

Trauma documentation should include specifics about the crash dynamics and injury patterns.

Coding Guidelines

Inclusion Criteria

Use V42.6 When
  • According to ICD
  • 10 coding guidelines, external cause codes should be used in conjunction with the primary diagnosis code
  • 6 should be reported for the specific encounter related to the injury and must be supported by documentation detailing the circumstances of the accident

Exclusion Criteria

Do NOT use V42.6 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99284CPT Code

Emergency department visit, high severity

Clinical Scenario

Used when a passenger presents to the ED with significant injuries from a collision.

Documentation Requirements

Documentation must support the severity of the visit and the injuries sustained.

Specialty Considerations

Emergency medicine specialists should ensure that the visit level reflects the complexity of the case.

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 those involving two- or three-wheeled vehicles. This specificity enhances data collection for public health and safety initiatives.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of external causes of injuries, including those involving two- or three-wheeled vehicles. This specificity enhances data collection for public health and safety initiatives.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of external causes of injuries, including those involving two- or three-wheeled vehicles. This specificity enhances data collection for public health and safety initiatives.

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 coded with V42.6?

V42.6 is used for a variety of injuries sustained by car passengers in collisions with two- or three-wheeled vehicles, including fractures, lacerations, and head injuries.

How can I ensure accurate coding for V42.6?

Ensure that all documentation clearly describes the accident circumstances, the type of vehicles involved, and the specific injuries sustained by the passenger.