roller skate injury

ICD-10 Primer, Lesson 2: Roller-Skate Documentation

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A minute doesn’t go by at work without someone talking about yet another patient involved in some roller-skating injury.  ICD-9 codes for roller-skating were limited: E006.0 for “activities involving roller skating (inline) and skateboarding” and E885.1 for “accidental fall from roller skates.”  ICD-10 gets it right and acknowledges two major realities of modern health care: (1) the ‘80s are back and (2) roller skates are here to stay.

roller skate injuryThis lesson does not cover ice skates.

In the same way it is absolutely critical to identify the difference between heart failure with reduced versus preserved ejection fraction for treatment purposes, it is also absolutely critical to identify the difference between in-line and non-in-line roller-skates for treatment and billing purposes.  The medical community now understands the importance of making this distinction.  This coming academic year, medical school anatomy classes across the country will feature cadavers with different types of roller skates to help future doctors learn skate anatomy.

These are the first 6 ICD-10 codes on roller skates:

V00.111A – Fall from in-line roller skates, initial encounter
V00.111D – Fall from in-line roller skates, subsequent encounter
V00.111S – Fall from in-line roller skates, sequela
V00.121A – Fall from non-in-line roller skates, initial encounter
V00.121D – Fall from non-in-line roller skates, subsequent encounter
V00.121S – Fall from non-in-line roller skates, sequela

ICD-10 understands that injuries to a pedestrian on roller skates involves collisions with other vehicles such as a pedal cycle (V01.01X, V01.11X, and V01.91X codes); two- or three-wheeled motor vehicles (V02.01X, V02.11X, and V02.91X codes); car, pick-up truck, or van (V03.01X, V03.11X, and V03.91X codes); heavy transport vehicle or bus (V04.01X, V04.11X, and V04.91X codes); railway train or railway vehicles (V05.01X, V05.11X, and V05.91X codes); and other nonmotor vehicles (V06.01X, V06.11X, and V06.91X codes).  This is critical and we just as we know our muscles and bones by heart, we too should memorize these codes.

Just like it is absolutely critical to identify the vehicle against which a pedestrian on roller skates collides, it is also absolutely critical to identify traffic accident, nontraffic accident, or unspecified weather traffic or nontraffic accident.  For example, V01.01XA stands for “pedestrian on roller-skates injured in collision with pedal cycle in nontraffic accident, initial encounter,” V01.11XA stands for “pedestrian on roller-skates injured in collision with pedal cycle in traffic accident, initial encounter,” and V01.91XA stands for “pedestrian on roller-skates injured in collision with pedal cycle, unspecified whether traffic or nontraffic accident, initial encounter.”  Understanding these differences is crucial for the management of traumatic injuries.

One of the glaring weaknesses of ICD-10 regarding roller-skate codes is the lack of codes for a pedestrian on roller-skates injured in a collision with a non-vehicle, such as a brick wall, telephone pole, statue, tennis net, or sports mascot.

So remember, when evaluating and treating a patient with injuries sustained while on roller skates, do not focus on their symptoms and the extent of their injuries, instead ask three very important questions: (1) In-line or non-in-line skates? (2) What vehicle did you run into? and (3) Was it a traffic or nontraffic accident?  Your patient will thank you later.

Other ICD-10 lessons:
Lesson 1: Macaw Documentation
Lesson 3: Star Wars Codes
Lesson 4: Babystroller Documentation
Lesson 5: WTF Codes
Lesson 6: OMG Codes
Lesson 7: The Fortune Cookie “In Bed” Modifier
Quiz 1: Can You Spot the Y92 Code That Isn’t Real?

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