Is W16.311 a billable ICD-10-CM code?

No. W16.311 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does W16.311 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 W16.311?

W16.311 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

W16.311

W16.311 — Fall into other water striking water surface causing drowning and submersion

Non-billable headerICD-10-CM

W16.311 is a non-billable header ICD-10-CM code for fall into other 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 other water without fall (W73)

Other codes that can never be billed with W16.311

These codes carry an Excludes1 note pointing at W16.311. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading W16.311 alone.

W73Other specified cause of accidental non-transport drowning and submersion
W73.XXXAOther specified cause of accidental non-transport drowning and submersion, initial encounter
W73.XXXDOther specified cause of accidental non-transport drowning and submersion, subsequent encounter
W73.XXXSOther specified cause of accidental non-transport drowning and submersion, sequela

Risk adjustment

W16.311 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 W16.311 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 W16.311.

Drowning›in›specified place NEC›following›fall
Drowning›following›fall›into›water NOS›specified NEC
Fall, falling›into›water›in›specified water NEC›causing drowning

Code to one of these instead W16.311

3 child codes. Green means billable.

Related codes at this level

Codes that share W16.31. If W16.311 is not quite right, the correct code is usually one of these.

W16.312Fall into other water striking water surface causing other injury

Questions about W16.311

Is W16.311 a billable ICD-10-CM code?: No. W16.311 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does W16.311 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 W16.311?: W16.311 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.