National Health Statistics Reports
 

Number 100  January 23, 2017 

Proposed ICD–10–CM Surveillance Case 


Definitions for Injury Hospitalizations and 


Emergency Department Visits
 

by Holly B. Hedegaard, M.D., M.S.P.H., National Center for Health Statistics; and Renee L. Johnson, M.S.P.H., R.P.T., 

and Michael F. Ballesteros, Ph.D., M.S., National Center for Injury Prevention and Control

 Abstract 

This report describes a collaboration between the National Center for Health 

Statistics and the National Center for Injury Prevention and Control to develop 

proposed surveillance case definitions for injury hospitalizations and emergency 

department (ED) visits for use with administrative data sets coded using the 

International Classification of Diseases, Tenth Revision, Clinical Modification 

(ICD–10–CM). The proposed ICD–10–CM surveillance case definitions were 

developed by applying General Equivalence Mappings to the International 

Classification of Diseases, Ninth Revision, Clinical Modification (ICD–9–CM) 

definitions. As with the ICD–9–CM definitions, there are slight differences between 

the proposed ICD–10–CM surveillance case definition for injury hospitalizations and 

the one for ED visits. The inclusion criteria for an injury hospitalization requires a case 

to have a principal diagnosis of one of the included nature-of-injury (injury diagnosis) 

codes. The inclusion criteria for an injury ED visit requires the case to have either a 

principal diagnosis of one of the included nature-of-injury codes or the presence of 

selected external-cause codes. The ICD–10–CM nature-of-injury and external-cause 

codes included in the proposed definitions are presented and caveats for use of the 

proposed definitions are described. 

Keywords: International Classification of Diseases, Tenth Revision, Clinical 

Modification (ICD–10–CM) • administrative data • nonfatal injury • General 

Equivalence Mapping 

Introduction 

Over the past 2 decades, the Centers 

for Disease Control and Prevention’s 

(CDC) National Center for Health 

Statistics (NCHS) and the National 

Center for Injury Prevention and Control 

(NCIPC) have collaborated with injury 

surveillance and epidemiology partners 

to improve the use of data to monitor 

fatal and nonfatal injuries in the United 

States. One aspect of this collaboration 

is the development of standard case 

definitions for injury surveillance based 

on selected codes from the International 

Classification of Diseases (ICD) (1). 

Surveillance definitions provide uniform 

criteria for case selection to ensure the 

standard analysis and interpretation 

of surveillance data used to study and 

identify trends in a population. In 2003, 

NCHS and NCIPC representatives, 

in collaboration with other injury 

epidemiologists and researchers, served 

on an Injury Surveillance Workgroup 

(ISW) of the Safe States Alliance to 

develop a recommended surveillance 

case definition for injury hospitalizations 

based on codes from the International 

Classification of Diseases, Ninth 

Revision, Clinical Modification 

(ICD–9–CM) (2). The definition 

developed by ISW has been in use for 

more than a decade and serves as the 

standard for case selection and analysis 

for CDC’s Injury Indicators Reports (3). 

The ICD–9–CM surveillance 

definition for injury hospitalization is 

generally applied to hospital discharge 

data, which are often based on billing 

information collected using the 

Uniform Billing Form (UB–04) (4). 

Data sets based on UB–04 include 

ICD codes for the principal diagnosis 

(i.e., the condition that resulted in the 

patient being admitted for care) as 

well as other secondary diagnoses, 

complications, and comorbidities. In 

the ICD–9–CM surveillance definition, 

injury hospitalizations are defined as 

those hospitalizations with a principal 

diagnosis of ICD–9–CM codes 800–994, 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics
 

 

Page 2 National Health Statistics Reports  Number 100  January 23, 2017 

995.5, and 995.80–995.85, excluding 

909.3 and 909.5 (Table A). These 

nature-of-injury codes include diagnoses 

related to anatomic injuries, poisoning 

and toxic effects, late effects of injuries, 

traumatic complications, and child and 

adult maltreatment. Readmissions, 

transfers, and deaths in the hospital are 

included in this definition. Excluded from 

the definition are adverse effects from 

therapeutic use of drugs, adverse effects 

of medical or surgical care, and late 

effects of those adverse effects. 

In addition to the surveillance 

definition for injury hospitalization, an 

ICD–9–CM surveillance definition for 

emergency department (ED) visits for 

injury has also been established (5,6). 

Injury ED visits are defined as those 

visits with either a principal diagnosis of 

an ICD–9–CM code as listed in Table A 

or the presence of selected ICD–9–CM 

external-cause codes (7). For surveillance 

of injury ED visits, the selected 

ICD–9–CM external-cause codes include 

E800–E848, E850–E869, E880–E929, 

and E950–E999. These codes reflect the 

external-cause codes included in the 

CDC-recommended framework for 

reporting injury morbidity data by 

mechanism and intent of injury (7). 

As of October 2015, the U.S. 

Department of Health and Human 

Services (HHS) requires all hospitals 

and health care providers covered by 

the Health Insurance Portability and 

Accountability Act (HIPAA) to use the 

International Classification of Diseases, 

Tenth Revision, Clinical Modification 

(ICD–10–CM) to report medical 

information (8). ICD–10–CM, developed by 

NCHS for use in morbidity coding in the 

United States, has been publicly available 

for more than a decade (9). The coding 

structure of ICD–10–CM is foundationally 

based on the ICD–10 published by the 

World Health Organization; however, the 

classification scheme has been greatly 

expanded to capture the diagnostic detail 

needed in morbidity data. The 

ICD–10–CM code set has nearly five 

times the number of codes found in 

ICD–9–CM (approximately 68,000 

codes in ICD–10–CM compared with 

14,000 codes in ICD–9–CM), and has 

the potential to provide greater utility 

in capturing the detailed information 

needed for billing, documentation 

of clinical care, and public health 

surveillance and practice. Codes to 

describe injury, poisoning, and certain 

other consequences of external causes 

(i.e., nature-of-injury codes) are found 

in Chapter 19, and codes to describe 

external causes of morbidity (i.e., 

external-cause codes) are found in 

Chapter 20 of the ICD–10–CM code set 

(9). 

With the transition to the use 

of ICD–10–CM, a surveillance case 

definition for injury hospitalizations 

and ED visits based on ICD–10–CM is 

needed. For continuity and comparability 

with current practice, the proposed 

ICD–10–CM surveillance definitions 

should be based on the current 

ICD–9–CM definitions and should reflect 

similar concepts and decision-making 

principles regarding the codes to be 

included. 

This report describes the methods 

used to develop the proposed ICD–10–CM 

injury surveillance case definitions for 

injury hospitalizations and ED visits, the 

recommended codes for inclusion, and 

considerations that will require additional 

review when ICD–10–CM coded data 

become available for testing. 

Methods for Developing 

Proposed Case 

Definitions 

The approach used to develop the 

proposed ICD–10–CM surveillance 

definition for injury hospitalizations is 

summarized in the Figure. 

As with the ICD–9–CM definition, 

the proposed ICD–10–CM definition is 

based on selected ICD–10–CM natureTable A. Inclusion and exclusion criteria using ICD–9–CM nature-of-injury codes in the principal diagnosis field 

Nature-of-injury code Description 

Including: 

800–909.2, 909.4, 909.9 . . . . . . . . . . . . . . . . . . . . . . . . . . 

910–994.9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 

995.5–995.59. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 

995.80–995.85. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 

Excluding:
 

Codes below 800. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 

909.3, 909.5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 

995.0–995.4, 995.6–995.7, 995.86, 995.89, 995.9 . . . . . . 

996–999. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Fractures; dislocations; sprains and strains; intracranial injury; internal injury of thorax, abdomen, and pelvis; 

open wound of the head, neck, trunk, upper limb and lower limb; injury to blood vessels; late effects of injury, 

poisoning, toxic effects, and other external causes, excluding late effects of complications of surgical and 

medical care or drugs, medicinal or biological substances 

Superficial injury; contusion; crushing injury; effects of foreign body entering through orifice; burns; injury to 

nerves and spinal cord; traumatic complications and unspecified injuries; poisoning and toxic effects of 

substances; other and unspecified effects of external causes 

Child maltreatment syndrome 

Adult maltreatment, unspecified; adult physical abuse; adult emotional/psychological abuse; adult sexual abuse; 

adult neglect (nutritional); other adult abuse and neglect 

Health conditions other than injury 

Late effects of complications of surgical and medical care; late effects of adverse effects of drug, medicinal or 

biological substance 

Other anaphylactic shock; angioneurotic edema; unspecified adverse effect of drug, medicinal and biological 

substance; allergy, unspecified; shock due to anesthesia; anaphylactic shock due to adverse food reaction; 

malignant hyperpyrexia or hypothermia due to anesthesia 

Complications due to certain specified procedures; complications affecting specified body systems, not 

elsewhere classified (NEC); other complications of procedures, NEC; complications of medical care, NEC 
National Health Statistics Reports  Number 100  January 23, 2017	 Page 3 

of-injury codes. General Equivalence 

Mappings (GEMs) were applied to the 

ICD–9–CM case definition to generate 

a set of possible ICD–10–CM codes to 

consider for inclusion in the proposed 

ICD–10–CM case definition. GEMs, 

developed by NCHS and the Centers for 

Medicare & Medicaid Services (CMS), 

assist in translating between different 

versions of ICD (10). Application of 

GEMs resulted in a set of possible 

ICD–10–CM codes, some of which are 

S and T codes found in Chapter 19 of the 

ICD–10–CM code set and some of which 

are found in other chapters of ICD–10–CM. 

The S and T codes identified through the 

GEM process were compared with all S 

and T codes from Chapter 19 to identify 

additional S and T codes that should be 

considered for inclusion in the proposed 

ICD–10–CM surveillance definition. 

Codes from the GEM process that are not 

S or T codes (see Technical Notes) were 

also reviewed. As a final step, GEMs 

were applied to the ICD–9–CM codes 

that are specifically excluded from the 

ICD–9–CM injury definition to determine 

whether any additional S or T codes 

should be included in the proposed 

ICD–10–CM definition. None were 

identified. 

As noted earlier, the ICD–9–CM 

surveillance definition for injury 

ED visits differs slightly from that 

of the surveillance definition for 

hospitalizations. The ICD–9–CM 

surveillance definition for ED visits 

is based on the presence of either an 

included nature-of-injury code as the 

principal diagnosis or the presence of 

one of the included external-cause codes. 

To create the proposed ICD–10–CM 

surveillance definition for injury ED 

visits, a list of included ICD–10–CM 

external-cause codes comparable with 

the included ICD–9–CM external-cause 

codes is also needed. Using a similar 

GEM process, selected ICD–10–CM 

external-cause codes comparable with 

those in the ICD–9–CM definition have 

been identified. The process for selecting 

these codes is described in a report that 

outlines the development of a proposed 

framework for reporting injury data by 

mechanism and intent of injury using 

ICD–10–CM external-cause-of-injury 

codes (11). All V, W, and X codes and 

selected Y codes from Chapter 20 of the 

Figure. Process for developing a proposed ICD–10–CM surveillance definition for injury 

hospitalizations 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ICD–10–CM code set are included. Some 

of the external causes included as E codes 

in ICD–9–CM are assigned to nature-ofinjury codes (T codes) in ICD–10–CM 

(11). All of the T codes considered to 

contain external cause information are 

included in the list of selected natureof-injury codes for case selection in the 

proposed ICD–10–CM surveillance case 

definitions for injury hospitalizations and 

ED visits (Table B). 

Proposed Inclusion 

Criteria for ICD–10–CM 

Surveillance Case 

Definition for Injury 

Hospitalizations 

For administrative data coded in 

ICD–10–CM, an injury hospitalization is 

defined as a hospitalization record with a 

principal diagnosis of one of the natureof-injury codes from Table B. 

●	 As with the ICD–9–CM surveillance 

definition, cases are selected based 

on a principal diagnosis of one of 

the nature-of-injury codes listed in 

Table B. 

●	 As with the ICD–9–CM surveillance 

definition, codes related to adverse 

effects from therapeutic use of drugs 

are not included in the proposed 

ICD–10–CM surveillance definition 

for injury hospitalizations. 

●	 ICD–10–CM includes codes to 

indicate medical consequences 

that result from underdosing of 

drugs used therapeutically. For 

comparability with the ICD–9–CM 

surveillance definition, these codes 

are not included in the proposed 

ICD–10–CM surveillance definition 

for injury hospitalization. 

●	 A new concept in ICD–10–CM is 

the presence of a 7th character in 

the ICD–10–CM code that indicates 

the type of encounter when the 

diagnosis was made. A 7th character 
Page 4	 National Health Statistics Reports  Number 100  January 23, 2017 

definitions have not yet been tested Table B. ICD–10–CM nature-of-injury codes in the proposed surveillance definition for 


injury hospitalizations using actual ICD–10–CM coded data. 

ICD–10–CM nature-of-injury code1	 Types of injuries 

All S codes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

T07–T34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

T36–T50 with a 6th character of 1, 2, 3, or 4 (Exceptions: 

T36.9, T37.9, T39.9, T41.4, T42.7, T43.9, T45.9, T47.9, 

and T49.9 with a 5th character of 1, 2, 3, or 4) . . . . . . . . . 

T51–T65 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

T66–T76 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

T79 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Anatomic injuries 

Foreign bodies, burns, corrosions, frostbite 

Drug poisoning (excludes adverse effects and 

underdosing) 

Toxic effects of substances nonmedicinal as to 

source 

Other and unspecified effects of external causes 

(radiation, heat, light, hypo/hyperthermia, 

asphyxiation, child/adult abuse, lightning, drowning, 

motion sickness) 

Certain early complications of trauma, not elsewhere 

classified 

1

Any 7th character except S (sequela from previous injury). T07, T14, and T30–T32 do not have a 7th character. 

of A, B, or C indicates an initial 

encounter with each care provider; 

a character of D through R indicates 

a subsequent encounter with the 

care provider; and a character of S 

indicates sequelae from a previous 

injury (12). For comparability with 

the current ICD–9–CM surveillance 

definition, only codes with a 7th 

character of A through R or missing 

a 7th character are included. Records 

with a principal diagnosis of one of 

the codes listed in Table B with a 7th 

character of S are excluded. 

Proposed Inclusion 

Criteria for ICD–10–CM 

Surveillance Case 

Definition for Injury ED 

Visits 

For administrative data coded in 

ICD–10–CM, an ED visit for injury is 

defined as an ED record with a principal 

diagnosis of one of the nature-of-injury 

codes from Table B or one of the selected 

external-cause-of-injury codes listed in 

Table C. For the external-cause codes: 

●	 All V, W, and X codes are included. 

●	 Only selected Y codes are included. 

Y codes not considered for injury 

surveillance purposes include 

Y62–Y84, Complications of medical 

and surgical care; and 

Y90–Y99, Supplementary factors 

related to causes of morbidity 

classified elsewhere. 

●	 As with nature-of-injury codes, 

ICD–10–CM external-cause-ofinjury codes also include a 7th 

character to indicate the type of 

encounter when the diagnosis was 

made. In the proposed ICD–10–CM 

surveillance definition for injury 

ED visits, only external-cause codes 

with a 7th character of A for initial 

encounter or D for subsequent 

encounter, or for which the 7th 

character is missing, are included. 

Discussion 

Standard surveillance case 

definitions for injury hospitalizations and 

ED visits have been used in the United 

States for more than a decade (2,6). 

Routine use of these surveillance case 

definitions allows for the comparison 

of rates across jurisdictions (e.g., 

states, national) and over time. NCHS 

and NCIPC have promoted the use of 

these standard definitions, for example, 

by incorporating them as integral 

components for case selection in CDC’s 

Injury Indicators Reports (3). 

The HHS requirement that hospitals 

and health care providers use 

ICD–10–CM to code clinical data 

beginning on October 1, 2015, 

necessitated the development of new 

surveillance case definitions based on the 

ICD–10–CM code set. 

To maintain consistency with 

the existing definitions, the proposed 

ICD–10–CM definitions were developed 

by applying GEMs to the ICD–9–CM 

definitions. Although this method is 

a reasonable approach, the proposed 

The proposed definitions are meant as 

a common starting place for further 

exploration. As ICD–10–CM coded 

data become more widely available and 

studies are conducted to test the proposed 

definitions, NCHS and NCIPC will revise 

the definitions as needed and publish final 

recommendations. 

When using the proposed definitions, 

researchers and epidemiologists should 

consider several issues: 

●	 The proposed definitions were 

developed for the purposes of injury 

surveillance and are considered 

surveillance case definitions, not 

clinical case definitions. Surveillance 

definitions are designed to study 

trends in a population by providing 

standardized criteria for selecting 

and aggregating cases for analysis. 

This is in contrast to clinical case 

definitions that generally use 

clinical, diagnostic, and laboratory 

data to determine a diagnosis for an 

individual patient. 

●	 A key concept in the proposed 

surveillance definitions is selection 

based on an included natureof-injury code as the principal 

diagnosis, rather than selection 

based on any mention of an included 

nature-of-injury code. The use of 

principal diagnosis is consistent with 

previous practice and allows for 

standardized implementation (2). 

For data based on UB–04, the 

principal diagnosis field is the one 

diagnostic field for which there is a 

generally accepted coding rule—it 

contains the code corresponding to 

the reason the patient was admitted, 

as determined by the attending 

physician or nurse. For the other 

diagnostic fields, no national 

standard has been established for 

the order in which the codes are 

assigned. Therefore, the presence 

of an injury diagnosis code in other 

fields does not necessarily identify 

an injury of sufficient severity to 

warrant hospitalization or an ED 

visit on its own. For consistency, 

the concept of selection based 

on principal diagnosis has been 

maintained in the proposed 
 

 

National Health Statistics Reports  Number 100  January 23, 2017	 Page 5 

Table C. ICD–10–CM external-cause-of-injury codes in the proposed surveillance 

definition for injury emergency department visits 

ICD–10–CM codes1 Types of external causes of injury 

V00–V99 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Transport accidents 

W00–X58. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other external causes of accidental injury 

X71–X83 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Intentional self-harm 

X92–Y09 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Assault 

Y21–Y33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Y35–Y38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Event of undetermined intent 

Legal intervention, operations of war, military 

operations and terrorism 

1

7th character of A, D, or 7th character missing. 

ICD–10–CM definitions; however, 

the implications of this choice should 

be considered when testing the new 

proposed surveillance definitions. 

●	 ICD–10–CM nature-of-injury and 

external-cause-of-injury codes 

have a 7th character that indicates 

whether the visit represents an initial 

encounter (7th character of A, B, or 

C for nature-of-injury codes, A for 

external-cause codes), subsequent 

encounter (D through R for natureof-injury codes, D for external-cause 

codes), or sequelae of an injury 

(S for both nature-of-injury codes 

and external-cause codes). In 

developing the proposed ICD–10–CM 

surveillance definitions, a decision 

was made to include only those 

codes that represent an initial or 

subsequent encounter or for which 

the 7th character is missing. Codes 

with a 7th character indicating 

sequelae of an injury are not included 

in the proposed case definitions. 

This difference (i.e., inclusion of late 

effects of injury in the ICD–9–CM 

definition and exclusion of late 

effects or sequelae in the ICD–10–CM 

definition) should be noted when 

comparing results from ICD–9–CM 

coded data and ICD–10–CM coded 

data. As data become available, 

it will be important to assess the 

implications of including only initial 

and subsequent encounters and 

excluding codes that reflect sequelae 

of injury. 

●	 ICD–10–CM includes an 

extensive number of codes 

that describe adverse effects of 

drugs and conditions resulting 

from underdosing of drugs. 

While these codes are in the 

same range as the poisoning (or 

“overdose”) codes (T36–T50), 

many injury epidemiologists and 

researchers argue that adverse 

effects and conditions resulting 

from underdosing should not be 

included for the purposes of injury 

surveillance. The decision to exclude 

these codes should continue to be 

evaluated before the surveillance 

case definitions are finalized. 

●	 The proposed ICD–10–CM 

surveillance case definitions 

described in this report were 

specifically developed to identify 

injury hospitalizations and ED visits 

using administrative data based on 

UB–04. The proposed definitions 

might not be directly applicable to 

other data sets for injury morbidity, 

such as data sets from paramedic 

trip reports, outpatient settings, or 

syndromic surveillance systems. 

Testing and validation of these 

definitions using data from other 

sources should be conducted to 

determine whether the definitions 

can be used directly or if they need 

to be modified for application to a 

particular data source. 

●	 Each year, NCHS and CMS update 

the ICD–10–CM code set to add or 

delete codes, revise descriptions, 

modify includes-and excludesnotes, and make other adjustments 

as needed. Thus, the surveillance 

definitions will continually need to 

be updated to address future changes 

to the ICD–10–CM code set. 

Conclusions 

The proposed ICD–10–CM 

surveillance definitions for injury 

hospitalizations and ED visits provide 

a common starting point for injury 

epidemiologists, researchers, and others 

to begin exploring the implications of the 

new ICD–10–CM classification system 

on injury surveillance. Because the 

proposed definitions have not been tested 

using actual ICD–10–CM coded data or 

by medical record review to confirm the 

accuracy of case selection based on the 

definitions, the proposed definitions are 

not considered to be final. NCHS and 

NCIPC will continue to collaborate with 

injury researchers and epidemiologists to 

test the case definitions and determine the 

sensitivity and specificity of the proposed 

surveillance definitions. As more is 

learned about the subtleties of ICD–10–CM 

coded data and as validation studies are 

completed, modifications may be needed 

before the definitions are finalized. 

References 

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and disability. Hyattsville, MD. 

Available from: http://www.cdc.gov/ 

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recommendations for using hospital 

discharge data for injury surveillance. 

Marietta, GA. 2003. Available from: 

http://c.ymcdn.com/sites/www. 

safestates.org/resource/resmgr/ 

imported/HospitalDischargeData.pdf. 

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injury indicators report: Instructions 

for preparing 2013 data. Atlanta, 

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and Prevention, National Center for 

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UB042016TOC.pdf. 
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emergency departments for use with 

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ecode_matrix.html. 

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(ICD–10–CM). Hyattsville, MD. 

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ICD–10–CM and ICD–10–PCS. 

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icd/10cmguidelines_2017_final.pdf. 
National Health Statistics Reports  Number 100  January 23, 2017	 Page 7 

Technical Notes 

In developing the proposed 

International Classification of Diseases, 

Tenth Revision, Clinical Modification 

(ICD–10–CM) surveillance definitions 

for injury hospitalizations and emergency 

department (ED) visits, General 

Equivalence Mappings (GEMs) (9) 

were applied to the nature-of-injury 

codes in the International Classification 

of Diseases, Ninth Revision, Clinical 

Modification (ICD–9–CM) case 

definition. This generated a set of 

possible ICD–10–CM codes to consider 

for inclusion in the ICD–10–CM case 

definition. The application of GEMs 

resulted in a set of possible ICD–10–CM 

codes, some of which are S and T codes 

found in Chapter 19 of the ICD–10–CM 

code set and some of which are found 

in other ICD–10–CM chapters. Codes 

from the GEM process that are not S or T 

codes are listed in the next section. Most 

of these codes are related to late effects of 

injuries and resulted from application of 

GEMs to ICD–9–CM codes 905.2–905.5 

and 905.8, Late effects of injury. These 

codes are not included in the proposed 

surveillance case definitions. 

ICD–10–CM codes from 

application of GEMs to 

ICD–9–CM surveillance 

definitions that are not 

S or T codes 

1.		L08.89, Other local infections of the 

skin 

a.		ICD–9–CM codes for superficial 

injuries with infection are mapped 

to two codes in ICD–10–CM: one 

for the specific superficial injury 

and L08.89, Other local infections 

of the skin. 

b. L08.89 is not included in the 

proposed surveillance definitions; 

however, the codes for the 

superficial injuries are included. 

2.		L59.9, Disorder of the skin, 

subcutaneous related to radiation 

a.		Mapped from ICD–9–CM code 

909.2, Late effect of radiation. 

b.		Not included in the proposed 

surveillance definitions because it 

corresponds to an ICD–9–CM 

late-effect code. 

3.		 M1A.10X1, Lead-induced chronic 

gout, unspecified 

a.		Mapped from ICD–9–CM code 

984.9, Toxic effect of unspecified 

lead compound. 

b. 984.9 also maps to T56.0X1A– 

T56.0X4A, Toxic effects of 

lead and its compounds, which 

are included in the proposed 

surveillance definitions. 

4.		 M67.90, Unspecified disorder of 

synovium and tendon, unspecified site 

a.		Mapped from ICD–9–CM code 

905.8, Late effect of tendon injury. 

b.		Not included in the proposed 

surveillance definitions because it 

corresponds to an ICD–9–CM 

late-effect code. 

5.		 M84.369S, Stress fracture, 

unspecified tibia and fibula, sequelae 

a.		Mapped from ICD–9–CM code 

905.4, Late effect of fracture of 

lower extremities. 

b. 905.4 also maps to M84.376S, 

M84.453S, and M84.469S and 

S79.009S, S82.009S, S82.90XS, 

S92.909S, and S92.919S. 

c.		Not included in the proposed 

surveillance definitions because it 

reflects sequelae of an injury. 

6.		 M84.376S, Stress fracture, 

unspecified foot, sequelae 

a.		Mapped from ICD–9–CM code 

905.4, Late effect of fracture of 

lower extremities. 

b. 905.4 also maps to M84.369S, 

M84.453S, and M84.469S and 

S79.009S, S82.009S, S82.90XS, 

S92.909S, and S92.919S. 

c.		Not included in the proposed 

surveillance definitions because it 

reflects sequelae of an injury. 

7.		 M84.40XS, Pathological fracture, 

unspecified site, sequelae 

a.		Mapped from ICD–9–CM code 

905.5, Late effect of fracture of 

multiple and unspecified bones. 

b.		Not included in the proposed 

surveillance definitions because it 

reflects sequelae of an injury. 

8.		 M84.429S, Pathological fracture, 

unspecified humerus, sequelae 

a.		Mapped from ICD–9–CM code 

905.2, Late effect of fracture of 

upper extremities. 

b. 905.2 also maps to M84.439S and 

S42.209S, S42.309S, S42.409S, 

S42.90XS, S52.90XS, and 

S62.90XS. 

c.		Not included in the proposed 

surveillance definitions because it 

reflects sequelae of an injury. 

9.		 M84.439S, Pathological fracture, 

unspecified ulna and radius, sequelae 

a.		Mapped from ICD–9–CM code 

905.2, Late effect of fracture of 

upper extremities. 

b. 905.2 also maps to M84.429S and 

S42.209S, S42.309S, S42.409S, 

S42.90XS, S52.90XS, and 

S62.90XS. 

c.		Not included in the proposed 

surveillance definitions because it 

reflects sequelae of an injury. 

10. M84.453S, Pathological fracture, 

unspecified femur, sequelae 

a.		Mapped from ICD–9–CM code 

905.4, Late effect of fracture of 

lower extremities. 

b. 905.4 maps to M84.369S, 

M84.376S, and M84.469S and 

S79.009S, S82.009S, S82.90XS, 

S92.909S, and S92.919S. 

c.		Not included in the proposed 

surveillance definitions because it 

reflects sequelae of an injury. 

11. M84.459S, Pathological fracture, hip, 

unspecified, sequelae 

a.		Mapped from ICD–9–CM code 

905.3, Late effect of fracture of 

neck of femur. 

b. 905.3 also maps to S72.009S, 

Fracture of unspecified part of 

neck of unspecified femur. 

c.		Not included in the proposed 

surveillance definitions because it 

reflects sequelae of an injury. 

12. M84.469S, Pathological fracture, 

unspecified tibia and fibula, sequelae 

a.		Mapped from ICD–9–CM code 

905.4, Late effect of fracture of 

lower extremities. 

b. 905.4 maps to M84.369S, 

M84.376S, and M84.453S and 

S79.009S, S82.009S, S82.90XS, 

S92.909S, and S92.919S. 

c.		Not included in the proposed 

surveillance definitions because it 

reflects sequelae of an injury. 

13. M84.48XS, Pathological fracture, 

other site, sequelae 

a.		Mapped from ICD–9–CM code 

905.5, Late effect of fracture of 

multiple and unspecified bones. 

b.		Not included in the proposed 

surveillance definitions because it 

reflects sequelae of an injury. 
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National Health Statistics Reports   Number 100  January 23, 2017
 

Suggested citation 

Hedegaard HB, Johnson RL, Ballesteros 

MF. Proposed ICD–10–CM surveillance case 

definitions for injury hospitalizations and 

emergency department visits. National health 

statistics reports; no 100. Hyattsville, MD: 

National Center for Health Statistics. 2017. 

Copyright information 

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated. 

National Center for Health Statistics 

Charles J. Rothwell, M.S., M.B.A., Director 

Jennifer H. Madans, Ph.D., Associate Director 

for Science 

Office of Analysis and Epidemiology 

Irma E. Arispe, Ph.D., Director 

Makram Talih, Ph.D., Associate Director for 

Science 

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