W16.0

W16.0: Fall into swimming pool

Non-billable headerICD-10-CM

W16.0 is a non-billable header ICD-10-CM code for fall into swimming pool. 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.

fall into empty swimming pool (W17.3)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Fall into swimming pool NOS

Excludes1 inherited from the categories above W16.0

A category’s note binds every code beneath it.

Written on W16: Fall, jump or diving into water

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 inherited from the categories above W16.0

Not part of this code, but both may be coded when both are present.

Written on W16: Fall, jump or diving into water

striking or hitting diving board (W21.4)

Other codes that can never be billed with W16.0

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
W67Accidental drowning and submersion while in swimming-pool
W67.XXXAAccidental drowning and submersion while in swimming-pool, initial encounter
W67.XXXDAccidental drowning and submersion while in swimming-pool, 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 W16.0

3 child codes. Green means billable.