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V86.35XA ICD-10-CM Code: Unspecified occupant of 3- or 4- wheeled all-terrain vehicle (ATV) injured in traffic accident, initial encounter

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

7th character
Required — see the character table on this page
Tabular directives
3 Excludes1

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for V86.35XA in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on V86.35XA itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from V86

7th Character Guide

"The appropriate 7th character is to be added to each code from category V86"

  • A — initial encounter (this page’s code)
  • D — subsequent encounter
  • S — sequela

How the encounter character is assigned. “Initial encounter” means the patient is receiving active treatment for the condition — it is not limited to the first visit, and a different or new provider giving active treatment still assigns it. “Subsequent encounter” covers care during the healing or recovery phase after active treatment. “Sequela” is for complications or conditions that arise as a direct result of the original condition.

ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.19.a (paraphrased by MedCoder).

Variant codes in this family

V86.35XA, V86.35XD, V86.35XS

Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.

Coder workflow for V86.35XA

MedCoder structured workflow — derived from this code’s own official record

Before you code V86.35XA

  1. Unspecified does not mean incorrect. When the record gives no greater specificity, V86.35XA may be the appropriate code. Check the record for detail that supports a more specific sibling. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

  2. A 7th character is required in this family. Confirm the documented encounter: initial (active treatment), subsequent (healing or recovery phase), or sequela. This page’s code carries “A”. “Initial” means active treatment, not the first visit (Guidelines I.C.19.a).

    See the 7th Character Guide · Guide: 7th characters: initial, subsequent, sequela →

  3. An external cause code is reported in addition to the code for the injury or condition, never as the principal or first-listed diagnosis. Confirm the cause, intent, place of occurrence, activity and status where the record documents them, and assign the 7th character that matches the injury code. External cause coding guidelines (Guidelines I.C.20.a).

  4. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with V86.35XA. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the record document the detail a more specific sibling code needs?
    Yes → Review the specific siblings in this subcategory.
    No → Continue — V86.35XA is appropriate when the documentation goes no further.
  2. Does the documentation support a condition named in V86.35XA’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewW31

  3. Is the encounter phase documented — active treatment, healing or recovery, or a sequela?
    Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
    No → The code is invalid without its 7th character — query for the missing element.

Consider V86.35XA. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Encounter type
Active treatment, healing or recovery phase, or sequela — the basis of the 7th character (Guidelines I.C.19.a).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Excludes1 — check before selecting V86.35XA(3 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with V86.35XA: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareW31

    See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.

Coding question: Is a more specific sibling code supportable?

Path: Review the subcategory for a sibling that names the missing detail.

Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).

Documentation: Both the condition V86.35XA describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewW31

Documentation: The patient returns during the healing or recovery phase after active treatment of the same condition.

Coding question: Which 7th character applies?

Path: Review the official 7th-character definitions for this family in the 7th Character Guide.

Reason: “Initial encounter” means active treatment, not the first visit; care during recovery takes “subsequent encounter”, and a complication arising from the original condition takes “sequela” (Guidelines I.C.19.a).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Unspecified occupant of 3- or 4- wheeled all-terrain vehicle (ATV) injured in traffic accident, initial encounter is a billable ICD-10-CM diagnosis code (V86.35XA).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

  • Principal-diagnosis restriction. External cause of morbidity codes (V, W, X and Y) describe the circumstance that caused an injury, not the condition treated. The Medicare Code Editor rejects them as a principal diagnosis; sequence the injury or condition first and report this code as secondary.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name V86.35XA or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 11 Excludes1 notes: V30 — Occupant of three-wheeled motor vehicle injured in collision with pedestrian or animal (via V86.-), V30-V39 — Occupant of three-wheeled motor vehicle injured in transport accident (V30-V39) (via V86.-), V31 — Occupant of three-wheeled motor vehicle injured in collision with pedal cycle (via V86.-), V32 — Occupant of three-wheeled motor vehicle injured in collision with two- or three-wheeled motor vehicle (via V86.-), V33 — Occupant of three-wheeled motor vehicle injured in collision with car, pick-up truck or van (via V86.-), V34 — Occupant of three-wheeled motor vehicle injured in collision with heavy transport vehicle or bus (via V86.-), V35 — Occupant of three-wheeled motor vehicle injured in collision with railway train or railway vehicle (via V86.-), V36 — Occupant of three-wheeled motor vehicle injured in collision with other nonmotor vehicle (via V86.-), V37 — Occupant of three-wheeled motor vehicle injured in collision with fixed or stationary object (via V86.-), V38 — Occupant of three-wheeled motor vehicle injured in noncollision transport accident (via V86.-), V39 — Occupant of three-wheeled motor vehicle injured in other and unspecified transport accidents (via V86.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Clinical classification (AHRQ CCSR):EXT007 — External cause codes: motor vehicle traffic (MVT); initial encounter; EXT020 — External cause codes: intent of injury, accidental/unintentional.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (External cause codes: motor vehicle traffic (MVT); initial encounter, External cause codes: intent of injury, accidental/unintentional).

+2316 more

Contextual Map

Every relationship of V86.35XA in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run V86.35XA with these 8 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes (11)

Clinical classification (CCSR)

Nearest codes (40)

Change history

Common coding questions

Does V86.35XA require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category V86.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

  • FY2018 — October 1, 2017
    Added to the code set
    Unspecified occupant of 3- or 4- wheeled all-terrain vehicle (ATV) injured in traffic accident, initial encounter
    FY2018 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to V86.35XA in its code family, with their registry titles.

View all codes in the V86 family