Chapter XX

External causes of morbidity and mortality
(V01-Y98)

This chapter, which in previous revisions of ICD constituted a supplementary classification, permits the classification of environmental events and circumstances as the cause of injury, poisoning and other adverse effects. Where a code from this section is applicable, it is intended that it shall be used in addition to a code from another chapter of the Classification indicating the nature of the condition. Most often, the condition will be classifiable to Chapter XIX, Injury, poisoning and certain other consequences of external causes (S00-T98). Causes of death should preferably be tabulated according to both Chapter XIX and Chapter XX, but if only one code is tabulated then the code from Chapter XX should be used in preference. Other conditions that may be stated to be due to external causes are classified in Chapters I to XVIII. For these conditions, codes from Chapter XX should be used to provide additional information for multiple-condition analysis only.

Categories for sequelae of external causes of morbidity and mortality are included at Y85-Y89.

This chapter contains the following blocks:
V01-X59 Accidents
V01-V99 Transport accidents
V01-V09 Pedestrian injured in transport accident
V10-V19 Pedal cyclist injured in transport accident
V20-V29 Motorcycle rider injured in transport accident
V30-V39 Occupant of three-wheeled motor vehicle injured in transport accident
V40-V49 Car occupant injured in transport accident
V50-V59 Occupant of pick-up truck or van injured in transport accident
V60-V69 Occupant of heavy transport vehicle injured in transport accident
V70-V79 Bus occupant injured in transport accident
V80-V89 Other land transport accidents
V90-V94 Water transport accidents
V95-V97 Air and space transport accidents
V98-V99 Other and unspecified transport accidents
W00-X59 Other external causes of accidental injury
W00-W19 Falls
W20-W49 Exposure to inanimate mechanical forces
W50-W64 Exposure to animate mechanical forces
W65-W74 Accidental drowning and submersion
W75-W84 Other accidental threats to breathing
W85-W99 Exposure to electric current, radiation and extreme ambient air temperature and pressure
X00-X09 Exposure to smoke, fire and flames
X10-X19 Contact with heat and hot substances
X20-X29 Contact with venomous animals and plants
X30-X39 Exposure to forces of nature
X40-X49 Accidental poisoning by and exposure to noxious substances
X50-X57 Overexertion, travel and privation
X58-X59 Accidental exposure to other and unspecified factors
X60-X84 Intentional self-harm
X85-Y09 Assault
Y10-Y34 Event of undetermined intent
Y35-Y36 Legal intervention and operations of war
Y40-Y84 Complications of medical and surgical care
Y40-Y59 Drugs, medicaments and biological substances causing adverse effects in therapeutic use
Y60-Y69 Misadventures to patients during surgical and medical care
Y70-Y82 Medical devices associated with adverse incidents in diagnostic and therapeutic use
Y83-Y84 Surgical and other medical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure
Y85-Y89 Sequelae of external causes of morbidity and mortality
Y90-Y98 Supplementary factors related to causes of morbidity and mortality classified elsewhere

Place of occurrence code

The following categories are provided to identify the place of occurrence of the external causes where relevant. Place of occurrence should be coded separately from the codes W00-Y34.
0 Home
Apartment
Boarding-house
Caravan [trailer] park, residential
Farmhouse
Home premises
House (residential)
Noninstitutional place of residence
Private:
· driveway to home
· garage
· garden to home
· yard to home
Swimming-pool in private house or garden
Excludes: abandoned or derelict house (8)
home under construction but not yet occupied (6)
institutional place of residence (1)
1 Residential institution
Children's home
Dormitory
Home for the sick
Hospice
Military camp
Nursing home
Old people's home
Orphanage
Pensioner's home
Prison
Reform school
2 School, other institution and public administrative area
Building (including adjacent grounds) used by the general public or by a particular group of the public such as:
· assembly hall
· campus
· church
· cinema
· clubhouse
· college
· court-house
· dancehall
· day nursery
· gallery
· hospital
· institute for higher education
· kindergarten
· library
· movie-house
· museum
· music-hall
· opera-house
· post office
· public hall
· school (private)(public)(state)
· theatre
· university
· youth centre
Excludes: building under construction (6)
residential institution (1)
sports and athletics area (3)
3 Sports and athletics area
Baseball field
Basketball-court
Cricket ground
Football field
Golf-course
Gymnasium
Hockey field
Riding-school
Skating-rink
Squash-court
Stadium
Swimming-pool, public
Tennis-court
Excludes: swimming-pool or tennis-court in private home or garden (0)
4 Street and highway
Freeway
Motorway
Pavement
Road
Sidewalk
5 Trade and service area
Airport
Bank
Café
Casino
Garage (commercial)
Gas station
Hotel
Market
Office building
Petrol station
Radio or television station
Restaurant
Service station
Shop (commercial)
Shopping mall
Station (bus)(railway)
Store
Supermarket
Warehouse
Excludes: garage in private home (0)
6 Industrial and construction area
Building [any] under construction
Dockyard
Dry dock
Factory:
· building
· premises
Gasworks
Industrial yard
Mine
Oil rig and other offshore installations
Pit (coal)(gravel)(sand)
Power-station (coal)(nuclear)(oil)
Shipyard
Tunnel under construction
Workshop
7 Farm
Farm:
· buildings
· land under cultivation
Ranch
Excludes: farmhouse and home premises of farm (0)
8 Other specified places
Beach
Campsite
Canal
Caravan site NOS
Derelict house
Desert
Dock NOS
Forest
Harbour
Hill
Lake
Marsh
Military training ground
Mountain
Park (amusement) (public)
Parking-lot and parking-place
Pond or pool
Prairie
Public place NOS
Railway line
River
Sea
Seashore
Stream
Swamp
Water reservoir
Zoo
9 Unspecified place

Activity code

The following subclassification is provided for optional use in a supplementary character position with categories V01-Y34 to indicate the activity of the injured person at the time the event occurred. This subclassification should not be confused with, or be used instead of, the recommended categories provided to indicate the place of occurrence of events classifiable to W00-Y34.
0 While engaged in sports activity
Physical exercise with a described functional element such as:
· golf
· jogging
· riding
· school athletics
· skiing
· swimming
· trekking
· water-skiing
1 While engaged in leisure activity
Hobby activities
Leisure-time activities with an entertainment element such as going to the cinema, to a dance or to a party
Participation in sessions and activities of voluntary organizations
Excludes: sports activities (0)
2 While working for income
Paid work (manual)(professional)
Transportation (time) to and from such activities
Work for salary, bonus and other types of income
3 While engaged in other types of work
Domestic duties such as:
· caring for children and relatives
· cleaning
· cooking
· gardening
· household maintenance
Duties for which one would not normally gain an income
Learning activities, e.g. attending school session or lesson
Undergoing education
4 While resting, sleeping, eating or engaging in other vital activities
Personal hygiene
8 While engaged in other specified activities
9 During unspecified activity