Fall from, out of or through building or structure
In Slipping, tripping, stumbling and falls (W00-W19), chapter 20: External Causes of Morbidity
21 billable codes under W13: none are a CC or MCC; none map to an HCC.
Advertisements
Instructional notes
Also applies, from Slipping, tripping, stumbling and falls (W00-W19)
These notes sit on W00-W19 and apply to every code under it, including W13.
Excludes1: not coded here, use a different code
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
Covers how to report external cause codes (V00-Y99) describing cause, intent, place, activity, and status. They are never principal or first-listed, and reporting is voluntary unless required.
- General External Cause Coding Guidelines (page 88)
- Place of Occurrence Guideline (page 89)
- Activity Code (page 89)
- Place of Occurrence, Activity, and Status Codes Used with other External Cause Code (page 89)
- If the Reporting Format Limits the Number of External Cause Codes (page 90)
- Multiple External Cause Coding Guidelines (page 90)
- Child and Adult Abuse Guideline (page 90)
- Unknown or Undetermined Intent Guideline (page 91)
All codes under W13
W13 can't be used on a claim. Pick a billable code below; grey headings group them.
- W13.0Fall from, out of or through balcony
- W13.0XXAFall from, out of or through balcony, initial encounter
- W13.0XXDFall from, out of or through balcony, subsequent encounter
- W13.0XXSFall from, out of or through balcony, sequela
- W13.1Fall from, out of or through bridge
- W13.1XXAFall from, out of or through bridge, initial encounter
- W13.1XXDFall from, out of or through bridge, subsequent encounter
- W13.1XXSFall from, out of or through bridge, sequela
- W13.2Fall from, out of or through roof
- W13.2XXAFall from, out of or through roof, initial encounter
- W13.2XXDFall from, out of or through roof, subsequent encounter
- W13.2XXSFall from, out of or through roof, sequela
- W13.3Fall through floor
- W13.3XXAFall through floor, initial encounter
- W13.3XXDFall through floor, subsequent encounter
- W13.3XXSFall through floor, sequela
- W13.4Fall from, out of or through window
- W13.4XXAFall from, out of or through window, initial encounter
- W13.4XXDFall from, out of or through window, subsequent encounter
- W13.4XXSFall from, out of or through window, sequela
- W13.8Fall from, out of or through other building or structure
- W13.8XXAFall from, out of or through other building or structure, initial encounter
- W13.8XXDFall from, out of or through other building or structure, subsequent encounter
- W13.8XXSFall from, out of or through other building or structure, sequela
- W13.9Fall from, out of or through building, not otherwise specified
- W13.9XXAFall from, out of or through building, not otherwise specified, initial encounter
- W13.9XXDFall from, out of or through building, not otherwise specified, subsequent encounter
- W13.9XXSFall from, out of or through building, not otherwise specified, sequela
W13 MS-DRGs
This code does not group to an MS-DRG as a principal diagnosis.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Falls
Falls can be dangerous at any age. Babies and young children can get hurt falling off furniture or down the stairs. Older children may fall off playground equipment. For older adults, falls can be especially serious. They are at higher risk of falling. They are also more likely to fracture (break) a bone when they fall, especially if they have osteoporosis. A broken bone, especially when it is in a hip, may even lead to disability and a loss of independence for older adults.
Read more about falls on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.