W16

W16: Fall, jump or diving into water

Non-billable headerICD-10-CM

W16 is a non-billable header ICD-10-CM code for fall, jump or diving into water. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

The appropriate 7th character is to be added to each code from category W16

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

accidental non-watercraft drowning and submersion not involving fall (W65-W74)
effects of air pressure from diving (W94.-)
fall into water from watercraft (V90-V94)
hitting an object or against bottom when falling from watercraft (V94.0)

Excludes2: not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

striking or hitting diving board (W21.4)

Other codes that can never be billed with W16

Their own Excludes1 notes name this code, so the conflict is not listed above.

V90Drowning and submersion due to accident to watercraft
V92Drowning and submersion due to accident on board watercraft, without accident to watercraft
W17.3XXAFall into empty swimming pool, initial encounter
W17.3XXDFall into empty swimming pool, subsequent encounter
W17.3XXSFall into empty swimming pool, sequela
W18.2Fall in (into) shower or empty bathtub
W18.2XXAFall in (into) shower or empty bathtub, initial encounter
W18.2XXDFall in (into) shower or empty bathtub, subsequent encounter

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead W16

10 child codes. Green means billable.