Q&A: 2020 ICD-10-CM coding for legal interventions
Q: The 2020 ICD-10-CM update added several new codes for legal interventions. What are these codes, and can they be assigned based on nonphysician documentation?
A: Effective October 1, coders may report 26 new codes under code category Y35.- (legal intervention). A few new codes are:
- Y35.009, legal intervention involving unspecified firearm discharge, unspecified person injured
- Y35.019, legal intervention involving injury by machine gun, unspecified person injured
- Y35.029, legal intervention involving injury by handgun, unspecified person injured
All the new codes are used to report an unspecified person injured. These codes cannot be reported on a claim form for reimbursement; however, they can be used to establish liability and enable specific reporting for statistical purposes, such as tracking the various types of techniques used in legal interventions.
In addition, five new codes were added to subcategory Y35.83- (legal intervention involving a conducted energy device) to specify the person injured during the legal intervention involving the use of a conducted energy device such as a Taser or a stun gun. A few new codes are:
- Y35.831, legal intervention involving a conducted energy device, law enforcement official injured
- Y35.832, legal intervention involving a conducted energy device, bystander injured
- Y35.833, legal intervention involving a conducted energy device, suspect injured
In general, external cause codes may be assigned based on documentation provided by nonphysicians such as nurses or ambulatory workers.
Per Coding Clinic, First Quarter 2014, p. 19, if a physician doesn’t document external cause information, coders may use nonphysician documentation. If there is a conflict between the nonphysician and physician documentation, the physician’s documentation takes precedence.
Editor’s note: Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, CCDS-O, HCS-D, director of HIM and coding for HCPro in Middleton, Massachusetts, answered this question during the HCPro webinar, JustCoding's 2020 ICD-10-CM Code Updates.
This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.
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