Is W16.531D a billable ICD-10-CM code?

Yes. W16.531D is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does W16.531D 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 W16.531D?

W16.531D carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

W16.531D

W16.531D — Jumping or diving into swimming pool striking wall causing drowning and submersion, subsequent encounter

Billable / specific codeICD-10-CMPOA exempt

W16.531D is a billable, specific ICD-10-CM code for jumping or diving into swimming pool striking wall causing drowning and submersion, subsequent encounter. It is valid for submission on a claim.

7th character "D" — subsequent encounter

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

W16.531D 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.

Related codes at this level

Codes that share W16.531. If W16.531D is not quite right, the correct code is usually one of these.

Questions about W16.531D

Is W16.531D a billable ICD-10-CM code?: Yes. W16.531D is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does W16.531D 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 W16.531D?: W16.531D carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.