Is W16.111 a billable ICD-10-CM code?

No. W16.111 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does W16.111 sit in the tabular list?

External causes of morbidity (V00-Y99), in the block Slipping, tripping, stumbling and falls (W00-W19).

What cannot be coded together with W16.111?

W16.111 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

W16.111

W16.111 — Fall into natural body of water striking water surface causing drowning and submersion

Non-billable headerICD-10-CM

W16.111 is a non-billable header ICD-10-CM code for fall into natural body of water striking water surface causing drowning and submersion. 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.

drowning and submersion while in natural body of water without fall (W69)

Other codes that can never be billed with W16.111

These codes carry an Excludes1 note pointing at W16.111. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading W16.111 alone.

W69Accidental drowning and submersion while in natural water
W69.XXXAAccidental drowning and submersion while in natural water, initial encounter
W69.XXXDAccidental drowning and submersion while in natural water, subsequent encounter
W69.XXXSAccidental drowning and submersion while in natural water, sequela

Risk adjustment

W16.111 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

How W16.111 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to W16.111.

Drowning›in›natural water›following›fall
Drowning›following›fall›into›water NOS›natural(lake) (open sea) (river) (stream) (pond)
Fall, falling›into›water›in›natural body of water›causing drowning

Code to one of these instead W16.111

3 child codes. Green means billable.

Related codes at this level

Codes that share W16.11. If W16.111 is not quite right, the correct code is usually one of these.

W16.112Fall into natural body of water striking water surface causing other injury

Questions about W16.111

Is W16.111 a billable ICD-10-CM code?: No. W16.111 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does W16.111 sit in the tabular list?: External causes of morbidity (V00-Y99), in the block Slipping, tripping, stumbling and falls (W00-W19).
What cannot be coded together with W16.111?: W16.111 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.