Is W16.511 a billable ICD-10-CM code?

No. W16.511 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does W16.511 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 W16.511?

W16.511 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

W16.511

W16.511 — Jumping or diving into swimming pool striking water surface causing drowning and submersion

Non-billable headerICD-10-CM

W16.511 is a non-billable header ICD-10-CM code for jumping or diving into swimming pool 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 swimming pool without jumping or diving (W67)

Risk adjustment

W16.511 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 W16.511 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 W16.511.

Drowning›following›jump or dive›into›swimming-pool
Drowning›in›swimming-pool›following›dive or jump
Jumped, jumping›into water›in›swimming pool›causing drowning

Code to one of these instead W16.511

3 child codes. Green means billable.

Related codes at this level

Codes that share W16.51. If W16.511 is not quite right, the correct code is usually one of these.

W16.512Jumping or diving into swimming pool striking water surface causing other injury

Questions about W16.511

Is W16.511 a billable ICD-10-CM code?: No. W16.511 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does W16.511 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 W16.511?: W16.511 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.