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ICD-10 Guide
ICD-10 CodesV45.5

V45.5

Billable

Car driver injured in collision with railway train or railway vehicle in traffic accident

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

Code Description

ICD-10 V45.5 is a billable code used to indicate a diagnosis of car driver injured in collision with railway train or railway vehicle in traffic accident.

Key Diagnostic Point:

The ICD-10 code V45.5 is designated for cases where a car driver sustains injuries due to a collision with a railway train or railway vehicle while operating a motor vehicle. This code is crucial for accurately capturing the external cause of morbidity and mortality associated with traffic accidents involving trains. Such incidents often result in severe injuries or fatalities due to the significant mass and speed of trains compared to standard vehicles. Documentation should include details about the circumstances of the accident, the type of injuries sustained, and any contributing factors such as weather conditions or visibility issues. Accurate coding is essential for public health data, resource allocation, and understanding the epidemiology of traffic-related injuries.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Determining the specific circumstances of the collision.
  • Differentiating between injuries sustained from the vehicle versus the train.
  • Understanding the nuances of external cause coding.
  • Ensuring accurate documentation of the event and its context.

Audit Risk Factors

  • Inadequate documentation of the accident details.
  • Misclassification of the type of vehicle involved.
  • Failure to capture the external cause accurately.
  • Inconsistent coding practices among different coders.

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Emergency department notes must clearly document the mechanism of injury, including details of the collision and any immediate interventions.

Common Clinical Scenarios

Patients presenting with traumatic injuries following a train collision, including fractures, lacerations, and internal injuries.

Billing Considerations

Consideration of the patient's pre-existing conditions and how they may affect recovery from trauma.

Trauma Surgery

Documentation Requirements

Detailed operative reports and trauma assessments are necessary to capture the extent of injuries and surgical interventions.

Common Clinical Scenarios

Trauma cases involving multiple injuries from a train collision requiring surgical intervention.

Billing Considerations

Accurate coding of all injuries sustained and their relation to the external cause is critical for comprehensive care.

Coding Guidelines

Inclusion Criteria

Use V45.5 When
  • According to the ICD
  • CM coding guidelines, external cause codes should be used in conjunction with the primary diagnosis code
  • It is essential to report the external cause code to provide a complete picture of the injury's context

Exclusion Criteria

Do NOT use V45.5 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 severe injuries from a train collision.

Documentation Requirements

Documentation must reflect the severity of the injuries and the complexity of care provided.

Specialty Considerations

Emergency medicine specialists should ensure that all relevant details of the incident are captured.

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, improving the accuracy of data collection and analysis for public health initiatives related to traffic safety.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more granular coding of external causes, improving the accuracy of data collection and analysis for public health initiatives related to traffic safety.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more granular coding of external causes, improving the accuracy of data collection and analysis for public health initiatives related to traffic safety.

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 V45.5 be used?

V45.5 should be used when a car driver is injured in a collision with a railway train or railway vehicle during a traffic accident, and it must be supported by appropriate documentation in the medical record.