Is Y38.5 a billable ICD-10-CM code?

No. Y38.5 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does Y38.5 sit in the tabular list?

External causes of morbidity (V00-Y99), in the block Legal intervention, operations of war, military operations, and terrorism (Y35-Y38).

Y38.5

Y38.5 — Terrorism involving nuclear weapons

Non-billable headerICD-10-CM

Y38.5 is a non-billable header ICD-10-CM code for terrorism involving nuclear weapons. 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 Y38

A: initial encounter
D: subsequent encounter
S: sequela

Inclusion terms

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

Terrorism involving blast effects of nuclear weapon
Terrorism involving exposure to ionizing radiation from nuclear weapon
Terrorism involving fireball effect of nuclear weapon
Terrorism involving heat from nuclear weapon

Other codes that can never be billed with Y38.5

These codes carry an Excludes1 note pointing at Y38.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Y38.5 alone.

Y38.2Terrorism involving other explosions and fragments
Y38.3Terrorism involving fires, conflagration and hot substances

Risk adjustment

Y38.5 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.

Code to one of these instead Y38.5

1 child code. Green means billable.

Y38.5XTerrorism involving nuclear weapons

Related codes at this level

Codes that share Y38. If Y38.5 is not quite right, the correct code is usually one of these.

Questions about Y38.5

Is Y38.5 a billable ICD-10-CM code?: No. Y38.5 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does Y38.5 sit in the tabular list?: External causes of morbidity (V00-Y99), in the block Legal intervention, operations of war, military operations, and terrorism (Y35-Y38).