W16.011 vs W67.XXXD
W16.011 (Fall into swimming pool striking water surface causing drowning and submersion) compared with W67.XXXD (Accidental drowning and submersion while in swimming-pool, subsequent encounter), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. W16.011 carries an Excludes1 note covering W67.XXXD: “drowning and submersion while in swimming pool without fall (W67)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
No — do not report together. W67.XXXD carries an Excludes1 note covering W16.011: “accidental drowning and submersion due to fall into swimming pool (W16.011, W16.021, W16.031)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
No — do not report together. W67.XXXD carries an Excludes1 note covering W16.011: “accidental drowning and submersion due to fall into water (W16.-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| W16.011Fall into swimming pool striking water surface causing drowning and submersion | W67.XXXDAccidental drowning and submersion while in swimming-pool, subsequent encounter | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| Classification | V00-Y99 — External Causes of Morbidity (V00-Y99) | V00-Y99 — External Causes of Morbidity (V00-Y99) |
| Definition | Fall into swimming pool striking water surface causing drowning and submersion is a non-billable ICD-10-CM category code (W16.011). | Accidental drowning and submersion while in swimming-pool, subsequent encounter is a billable ICD-10-CM diagnosis code (W67D). |
| 7th character | The appropriate 7th character is to be added to each code from category W16 | The appropriate 7th character is to be added to code W67 |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources