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W16.42XD vs W65

W16.42XD (Fall into unspecified water causing other injury, subsequent encounter) compared with W65 (Accidental drowning and submersion while in bath-tub), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Relationship

Conflict

Excludes1 conflict

W16.42XD
Fall into unspecified water causing other injury, subsequent encounter
↔
W65
Accidental drowning and submersion while in bath-tub

Not coded here — these two are mutually exclusive.

“accidental non-watercraft drowning and submersion not involving fall (W65-W74)”

An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.

Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Can these codes be reported together?

No — do not report together. W16.42XD carries an Excludes1 note covering W65: “accidental non-watercraft drowning and submersion not involving fall (W65-W74)”

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

W16.42XDFall into unspecified water causing other injury, subsequent encounterW65Accidental drowning and submersion while in bath-tub
Billing statusBillableNon-billable header

Report instead: W65.XXXA, W65.XXXD, W65.XXXS

ClassificationV00-Y99 — External Causes of Morbidity (V00-Y99)V00-Y99 — External Causes of Morbidity (V00-Y99)
DefinitionFall into unspecified water causing other injury, subsequent encounter is a billable ICD-10-CM diagnosis code (W16.42D).Accidental drowning and submersion while in bath-tub is a non-billable ICD-10-CM category code (W65).
7th characterThe appropriate 7th character is to be added to each code from category W16The appropriate 7th character is to be added to code W65
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Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources