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W29.4 ICD-10-CM Code: Contact with nail gun

Compare with another code for W29.4Check this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

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

Not billable · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Excludes1Never report with this code
  • contact with commercial machinery (W31.82)
  • contact with hot household appliance (X15)
  • contact with nonpowered hand tool (W27.-)
  • exposure to electric current (W86)

+4 more in Instructions

Where it sits Source: CMS/NCHS

Under:Chapter 20: External Causes of MorbidityV00-X58 AccidentsW00-X58 Other external causes of accidental injuryW20-W49 Exposure to inanimate mechanical forcesW29 Contact with other powered hand tools and household machinery

Codes under W29.4 (3)

  • W29.4XXAContact with nail gun, initial encounterBillable
  • W29.4XXDContact with nail gun, subsequent encounterBillable
  • W29.4XXSContact with nail gun, sequelaBillable

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for W29.4 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on W29.4 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).

7th Character Guide

"The appropriate 7th character is to be added to each code from category W29"

  • A — initial encounter
  • 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

W29.4XXA, W29.4XXD, W29.4XXS

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 W29.4

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

Before you code W29.4

  1. W29.4 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewW29.4XXA, W29.4XXD, W29.4XXS

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. A 7th character is required in this family. Confirm the documented encounter: initial (active treatment), subsequent (healing or recovery phase), or sequela. W29.4 is not valid without one. “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 the code beneath W29.4. 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 documentation support one of the more specific codes beneath W29.4?
    Yes → Select that code and continue the checks below on its own page.
    No → W29.4 cannot be reported as written. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.

    ReviewW29.4XXA, W29.4XXD, W29.4XXS

  2. Does the documentation support a condition named in W29.4’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.

    ReviewW31.82, X15, W27, W86, Y36, Y37

  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.

Report the code beneath W29.4 that the documentation supports, not W29.4 itself. Then confirm that code is valid for the date of service on its own page.

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).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).

Official instructions as workflow

  • Excludes1 — check before selecting W29.4(8 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with W29.4: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareW31.82, X15, W27, W86, Y36, Y37

    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: Both the condition W29.4 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).

ReviewW31.82, X15, W27, W86, Y36, Y37

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.

Don’t confuse W29.4 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of W29.4 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • W31.82— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of contact with commercial machinery moves the case to W31.82; the two are not reported together unless documented as unrelated.

    Full comparison: W29.4 vs W31.82 →

  • X15— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of contact with hot household appliance moves the case to X15; the two are not reported together unless documented as unrelated.

    Full comparison: W29.4 vs X15 →

  • W27— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of contact with nonpowered hand tool moves the case to W27; the two are not reported together unless documented as unrelated.

    Full comparison: W29.4 vs W27 →

  • W86— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of exposure to electric current moves the case to W86; the two are not reported together unless documented as unrelated.

    Full comparison: W29.4 vs W86 →

  • X92— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of assault moves the case to X92; the two are not reported together unless documented as unrelated.

    Full comparison: W29.4 vs X92 →

  • Y09— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of assault moves the case to Y09; the two are not reported together unless documented as unrelated.

    Full comparison: W29.4 vs Y09 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Contact with nail gun is a non-billable ICD-10-CM category code (W29.4). A more specific billable subcode must be selected for claims submission.

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

  • Not billable as written — a more specific code is required: W29.4XXA, W29.4XXD, W29.4XXS.
  • Requires a 7th character. "The appropriate 7th character is to be added to each code from category W29" Options: W29.4XXA, W29.4XXD, W29.4XXS
  • 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-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name W29.4 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 25 Excludes1 notes: W00 — Fall due to ice and snow (via W29.-), W00-W19 — Slipping, tripping, stumbling and falls (W00-W19) (via W29.-), W01 — Fall on same level from slipping, tripping and stumbling (via W29.-), W03 — Other fall on same level due to collision with another person (via W29.-), W04 — Fall while being carried or supported by other persons (via W29.-), W05 — Fall from non-moving wheelchair, nonmotorized scooter and motorized mobility scooter (via W29.-), W06 — Fall from bed (via W29.-), W07 — Fall from chair (via W29.-), W08 — Fall from other furniture (via W29.-), W09 — Fall on and from playground equipment (via W29.-), W10 — Fall on and from stairs and steps (via W29.-), W11 — Fall on and from ladder (via W29.-), W12 — Fall on and from scaffolding (via W29.-), W13 — Fall from, out of or through building or structure (via W29.-), W14 — Fall from tree (via W29.-), W15 — Fall from cliff (via W29.-), W16 — Fall, jump or diving into water (via W29.-), W17 — Other fall from one level to another (via W29.-), W18 — Other slipping, tripping and stumbling and falls (via W29.-), W19 — Unspecified fall (via W29.-), +5 more.

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

Referenced by 1 Excludes2 note: W45 — Foreign body or object entering through skin (via W29.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Contextual Map

Every relationship of W29.4 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 W29.4 with these 9 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes (25)

Referenced by Excludes2 notes

External cause index

  • Contact (accidental), with, nail, gun[External cause term]— CMS External Cause of Injuries Index · icd10cm-fy2027
  • Contact (accidental), with, rivet gun (powered)[External cause term]— CMS External Cause of Injuries Index · icd10cm-fy2027
  • Nail, contact with, gun[External cause term]— CMS External Cause of Injuries Index · icd10cm-fy2027

Nearest codes (24)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed As (3)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Circumstance phrases from the official ICD-10-CM External Cause of Injuries Index that map to this code.

  • Contact (accidental), with, nail, gun
  • Contact (accidental), with, rivet gun (powered)
  • Nail, contact with, gun

Common coding questions

MedCoder editorial

Can W29.4 be billed directly?

No. W29.4 (Contact with nail gun) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Does W29.4 require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category W29.

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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-derived 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 editorial 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.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "W29.4 — Contact with nail gun." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/w29.4-contact-with-nail-gun

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Contact with nail gun

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to W29.4 in its code family, with their registry titles.

View all codes in the W29 family