V90 vs V91.18XA

V90 (Drowning and submersion due to accident to watercraft) compared with V91.18XA (Crushed between other unpowered watercraft and other watercraft or other object due to collision, initial encounter), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because V91.18XA lists V90 under Excludes2, which marks them as distinct conditions.

Official rule

What is different?

The conditions named and billing status.V90 is “Drowning and submersion due to accident to watercraft”; V91.18XA is “Crushed between other unpowered watercraft and other watercraft or other object due to collision, initial encounter”. V90 is a non-billable header; V91.18XA is billable.

Registry fact

Can these codes be reported together?

Yes, when both are documented.V91.18XA lists V90 under Excludes2: “drowning and submersion due to accident to watercraft (V90.-)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. V90 carries 4 Excludes1 notes and V91.18XA carries 2 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.V91.18XA’s tabular entry: “drowning and submersion due to accident to watercraft (V90.-)”. The note covers V90.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

One is a header.V90 is a non-billable header, but V91.18XA is not one of its subdivisions.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

V91.18XA

Crushed between other unpowered watercraft and other watercraft or other object due to collision, initial encounter

↔

V90

Drowning and submersion due to accident to watercraft

What we found

Yes, when both are documented.V91.18XA carries an Excludes2 note covering V90: “drowning and submersion due to accident to watercraft (V90.-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2 Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

Section I.A.12.b — Excludes2 · applies to: Excludes2
A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

	V90Drowning and submersion due to accident to watercraft	V91.18XACrushed between other unpowered watercraft and other watercraft or other object due to collision, initial encounter
Billing status	Non-billable header Report instead: V90.00XA, V90.00XD, V90.00XS, V90.01XA, V90.01XD	Billable
Classification	V00-Y99 — External Causes of Morbidity (V00-Y99)	V00-Y99 — External Causes of Morbidity (V00-Y99)
Definition	Drowning and submersion due to accident to watercraft is a non-billable ICD-10-CM category code (V90).	Crushed between other unpowered watercraft and other watercraft or other object due to collision, initial encounter is a billable ICD-10-CM diagnosis code (V91.18XA).
7th character	The appropriate 7th character is to be added to each code from category V90	The appropriate 7th character is to be added to each code from category V91
Includes	—	any injury except drowning and submersion as a result of an accident to watercraft Crushed between surfboard and other watercraft or other object due to collision Crushed between windsurfer and other watercraft or other object due to collision
Excludes1	civilian water transport accident involving military watercraft (V94.81-) fall into water not from watercraft (W16.-) military watercraft accident in military or war operations (Y36.0-, Y37.0-) water-transport-related drowning or submersion without accident to watercraft (V92.-)	civilian water transport accident involving military watercraft (V94.81-) military watercraft accident in military or war operations (Y36, Y37.-)
Excludes2	—	drowning and submersion due to accident to watercraft (V90.-)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2026). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources