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v1.0.0
ICD-10 Guide
ICD-10 CodesV55.4

V55.4

Billable

Person boarding or alighting a pick-up truck or van injured in collision with railway train or railway vehicle

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

Code Description

ICD-10 V55.4 is a billable code used to indicate a diagnosis of person boarding or alighting a pick-up truck or van injured in collision with railway train or railway vehicle.

Key Diagnostic Point:

The ICD-10 code V55.4 is used to classify injuries sustained by individuals who are boarding or alighting from a pick-up truck or van when involved in a collision with a railway train or railway vehicle. This code captures the external cause of morbidity and mortality related to transportation incidents, specifically those involving railways. Such incidents can result in severe injuries or fatalities due to the significant mass and speed of trains compared to smaller vehicles. Documentation should include details about the circumstances of the incident, the type of vehicle involved, and the nature of the injuries sustained. Accurate coding is crucial for public health data collection, resource allocation, and injury prevention strategies, as it helps identify patterns in transportation-related injuries and informs safety regulations.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the incident type (boarding/alighting)
  • Need for detailed documentation of the circumstances
  • Potential for multiple external cause codes to be applicable
  • Variability in injury severity and types

Audit Risk Factors

  • Inadequate documentation of the incident specifics
  • Misclassification of the type of vehicle involved
  • Failure to capture the boarding/alighting context
  • Inconsistent coding practices among different coders

Specialty Focus

Medical Specialties

Emergency Medicine

Documentation Requirements

Emergency department notes should clearly document the mechanism of injury, including details about the vehicle type and the circumstances of the collision.

Common Clinical Scenarios

Patients presenting with trauma after being struck while boarding or alighting from a vehicle, requiring immediate assessment and intervention.

Billing Considerations

Consideration of other injuries that may not be immediately apparent but could be related to the incident.

Trauma Surgery

Documentation Requirements

Trauma documentation must include a detailed account of the injury mechanism, including the speed of the train and the position of the patient at the time of impact.

Common Clinical Scenarios

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

Billing Considerations

Attention to potential complications arising from the nature of the injuries sustained.

Coding Guidelines

Inclusion Criteria

Use V55.4 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 in the secondary position to the primary diagnosis code reflecting the injury sustained

Exclusion Criteria

Do NOT use V55.4 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 railway vehicle collision.

Documentation Requirements

Documentation must support the level of service, including history, examination, and medical decision-making.

Specialty Considerations

Emergency medicine providers should ensure thorough documentation of the incident.

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, improving data accuracy and facilitating better public health tracking of transportation-related injuries.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of external causes of injuries, improving data accuracy and facilitating better public health tracking of transportation-related injuries.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of external causes of injuries, improving data accuracy and facilitating better public health tracking of transportation-related injuries.

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 V55.4?

Documentation should include details about the incident, such as the type of vehicle involved, the circumstances of boarding or alighting, and the nature of the injuries sustained.