Injury Data Introduction
Intermediate Injury Prevention
August 23-26, 2011 – Billings, MT
Injury Data Introduction
 Session Goal:
• Review injury data concepts fr: Intro to IP Course
• Understand classification system for injury
morbidity & mortality
 Session Objectives:
• Describe the uses of data
• Define types of data
• Identify common sources of injury data
• Describe classification system for injury coding
• Interpret listings of injury morbidity/mortality codes
In Review…
What are the two types of data?
(hint: words v. numbers)
How are data used in IP?
What are the sources of injury data?
Two Types of Data
Qualitative Data
Interviews
Surveys
Focus groups
Gives insight on
development of your
program/messages/
materials
Quantitative Data
Raw numbers
Counts
Identify injury
patterns
Surveillance
Observations
Risk assessments
Use of Data in Injury Prevention
Understand trends
patterns
Risk factors
Causes of injury in a
population
Set priorities for
prevention
Guide/persuade
decision makers
Develop a program
messaging &
materials (design of
float coats in AK;
safety message for
a targeted group)
Justify needs/build
your case for
funding (i.e., grants)
Evaluate your
program
Common sources of injury data?
Local IHS severe
injury surveillance
system
Resources and
patient management
system
Medical records &
death certificates
EMS & police
Questionnaires
Surveys
Focus groups
Key information
interviews
Observations (seat
belt surveys, home
safety assessments)
In Review…
What are the agents of injury?
(hint: Injury results from the transfer of energy)
What are the two main categories of
injury?
(hint: MVC and Domestic Violence are examples)
Agents of Injury
 Mechanical: crushing
injury in wringer
washer, energy
transferred during MV
crash
 Thermal: heat injuries –
fire, hot water scalding
 Chemical: battery acid
spills, poisoning
 Electrical: lightening
 Radiation: sunburn,
overexposure to x-ray
 Absence of oxygen:
drowning, suffocation,
smoke inhalation,
Carbon monoxide
 Absence of heat:
hypothermia, frostbite
 Excess heat: heat
stroke (hyperthermia)
Two Main Categories of Injury
Unintentional
Drowning
Fall
Fire
Burn
MVC
Poisoning
Intentional
Suicide
Self-Harm
Assault
Child Abuse
Elder Abuse
Domestic Violence
International Classification of Disease
Diagnosis Codes
Cause of Injury Codes
ICD-9 (Non-fatal)
ICD-10 (Deaths)
Diagnosis Codes
ICD-9
 Morbidity
 Required for Billing
 Numeric
 800-999
 Updated > annually
 Phase out: 2013
ICD-10
 Mortality
 Alphanumeric
 S00-T98
 Updated every Oct.
 Oct. 1, 2013 Morbidity
Diagnosis Codes - Examples
ICD-9
Fractures
Open Wound
Crushing
Burns
Poisoning
ICD-10
800-829
870-897
925-929
940-949
960-979
Injury to…
Head
Neck
Knee/Lower Leg
Mult. Body Parts
Burns & Corrosn
Frostbite
Poisoning
S00-S09
S10-S19
S80-S89
T00-T07
T20-T32
T33-T35
T36-T50
fx vault of skull; closed; 800.02
no intercranial injury
less than 1 hr LOC
See Reference Handout
External Cause of Injury Codes
ICD-9










Morbidity
Not required for billing
Numeric preceded by “E”
E800-E999
Allows for code for Place
Updated > annually
Phase out: 2013
State laws/coding rates vary
IHS hospital d/c rates: high
IHS ED & CHS rates: low
ICD-10

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
Mortality
Required for death certif
Alphanumeric
V01-Y98
Allows for code for Place
Allows for code for Activity
Updated every Oct.
Oct. 1, 2013 Morbidity
Diagnosis Codes - Examples
ICD-9
MV Traffic Accidents
Falls
Suicide/Self-Inflicted
Homicide (Assault)
ICD-10
E810-E819
E880-E888
E950-E959
E960-E969
Transport Accidents
Falls
Intentional Self-Harm
Assault
V01-V99
W00-W19
X60-X84
X85-Y09
See Reference Handout
Anatomy of an E-Code
E XXX.Y
Injury Category
Specificity
Anatomy of an E-Code
E 813.2
MVC; collision
w/other vehicle
Injured person was
a motorcyclist
Analysis of E-Codes
MVC
E800-E825
Fall
E880-E888
Fire
E890-E899
Suicide
Assault
E950-E959
E960-E969
E810.0
E819.1
E813.1
E814.7
E814.7
E814.7
E814.7
E816.0
E819.0
E880.1
E884.0
E884.0
E884.0
E884.0
E884.1
E885.2
E890.1
E890.3
E950.1
E955.0
E965.0
E966.0
MVC invol. pedestrian
Fall; playground equip.
E-Code Example: Falls
(E880-E888)
Fall from:
…escalator
…sidewalk curb
…building/structure
…well
…playground
…chair
…bed
…commode
…skateboard
…snowboard
…ladder
…scaffolding
…diving
…storm drain/manhole
…cliff
…wheelchair
…other furniture
…roller skates
…skis
…other/unspecified
Analysis of E-Codes
Falls E800-E888
E880.1
E880.9
E880.9
E884.2
E884.6
E888
E888
E888
E888
E888
E888
E888
E888
E888
Fall from sidewalk curb
Fall from stairs
Fall from chair
Fall from commode
Unspecified Fall
E-Codes Limitations
 Records Not Always E-coded
 Miscoding & Inconsistent Coding
 Poor Chart Info = Nonspecific E-Code
 Don’t Always Provide Desired Specificity
 Must Stay Apprised of Updates
Injury
Fatality
Hospitalization
E Coded on Death Certificate by Coroner
E Coded at Hospital
County Health Department
State Government
WISQARS Data System
(Web- Based)
National Center for Health
Statistics
External Cause of Injury
Coding References
 American Academy of Professional Coders
http://www.aapc.com/
 World Health Organization
http://www.who.int/classifications/icd/en/
 CDC National Center for Health Statistics
http://www.cdc.gov/nchs/icd.htm
 CDC article on improving E-coding
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5701a1.htm
E-Code Exercise
Searchable ICD-9 code: http://icd9cm.chrisendres.com/index.php