Obstetric and Gynecology Care Coding / Billing Guidelines

Obstetric and Gynecology Care Coding / Billing Guidelines

Obstetrics and Gynecology Care / Maternity care services are, 

1. Antepartum care
2. Delivery services
3. Postpartum care

There are 2 type of OB coding/billing guidelines are given below,

1. Global OB Care
2. Non-global OB care or partial services

Global OB Care

The total obstetric care package includes the provision of antepartum care, delivery services and postpartum care.

When the same group physician and/or other health care professional provides all components of the OB package, report the Global OB package code.

The CPT for Global OB codes are,

59400 – Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care

59510 – Routine obstetric care including antepartum care, cesarean delivery, and postpartum care

59610 – Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery

59618 – Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery

Billing Guidelines

The global maternity allowance is a complete, one-time billing which includes all professional services for routine antepartum care, delivery services, and postpartum care.

The fee is reimbursed for all of the member’s obstetric care to one provider.

If the member is seen four or more times prior to delivery for prenatal care and the provider performs the delivery, and performs the postpartum care then the provider must bill the Global OB code.

Global maternity billing ends with release of care within 42 days after delivery. Global OB care should be billed after the delivery date/on delivery date.

Services Included In Global Obstetrical Package,

• Routine prenatal visits until delivery, after the first three antepartum visits
  
• Recording of weight, blood pressures and fetal heart tones
  
• Admission to the hospital including history and physical
  
• Inpatient Evaluation and Management (E/M) service provided within 24 hours of delivery
  
• Management of uncomplicated labor
  
• Vaginal or cesarean section delivery
  
• Delivery of placenta (CPT code 59414)
  
• Administration/induction of intravenous oxytocin (CPT code 96365-96367)
  
• Insertion of cervical dilator on same date as delivery (CPT code 59200)
  
• Repair of first or second degree lacerations
  
• Simple removal of cerclage (not under anesthesia)
  
• Uncomplicated inpatient visits following delivery
  
• Routine outpatient E/M services provided within 42 days following delivery
  
• Postpartum care after vaginal or cesarean section delivery (CPT code 59430)
  

The above mentioned services are not separately reimbursed when reported separately from the global OB code.

As per ACOG (American College of Obstetricians and Gynecologists) coding guidelines, reporting of third and fourth degree lacerations should be identified by appending modifier 22 to the global OB code (CPT codes 59400 and 59610) or delivery only code (CPT codes 59409, 59410, 59612 and 59614)

Claims submitted with modifier 22 must include medical record documentation that supports the use of modifier.

Services Excluded from the Global Obstetrical Package,

The following services are excluded from the global OB package (CPT codes 59400, 59510, 59610, 59618) and may be reported separately.

• First three antepartum E&M visits
  
• Laboratory tests
  
• Maternal or fetal echography procedures (CPT codes 76801, 76802, 76805, 76810, 76811, 76812, 76813, 76814, 76815, 76816, 76817, 76820, 76821, 76825, 76826, 76827 and 76828)
  
• Amniocentesis, any method (CPT codes 59000 or 59001)
  
• Amniofusion (CPT code 59070)
  
• Chorionic villus sampling (CPT code 59015)
  
• Fetal contraction stress test (CPT code 59020)
  
• Fetal non-stress test (CPT code 59025)
  
• External cephalic version (CPT code 59412)
  
• Insertion of cervical dilator (CPT code 59200) more than 24 hr before delivery
  
• E&M services which is unrelated to the pregnancy (e.g. UTI, Asthma) during antepartum or postpartum care.
  
• Additional E/M visits for complications or high risk monitoring resulting in greater than the typical 13 antepartum visits. However these E/M services should not be reported until after the patient delivers. Append modifier 25 to identify these visits as separately identifiable from routine antepartum visits.
  
• Inpatient E/M services provided more than 24 hrs before delivery
  
• Management of surgical problems arising during pregnancy (e.g. Cholecystectomy, appendicitis, ruptured uterus)

Non-global OB care, or partial services

Non-global OB care, or partial services, refers to maternity care not managed by a single provider or group practice.

Billing for non-global OB or Partial care may occur if,

• A patient transfers into or out of a physician or group practice
  

• A patient is referred to another physician during her pregnancy
  

• A patient has the delivery performed by another physician or other health care professional not associated with her physician or group practice
  

• A patient terminates or miscarries her pregnancy
  

• A patient changes insurers during her pregnancy

The physician provide only partial services instead of global OB care, T bill for that portion of maternity care only.

Use the codes below for billing antepartum-only, postpartum-only, delivery-only, or delivery and postpartum only services.

Only one of the following options should be used, not a combination.

A. Antepartum care only

• For 1 to 3 visits: Use E/M office visit codes.
  
• For 4 to 6 visits: Use CPT 59425, This code must not be billed by the same provider in conjunction with one to three office visits, or in conjunction with code 59426.
  
• For 7 or more visits: Use CPT 59426 – Complete antepartum care is limited to one beneficiary pregnancy per provider.

Billing Guidelines

If the patient is treated for antepartum services only, the physician should use CPT code 59426 if 7 or more visits are provided, CPT code 59427 if 4-6 visits are provided, or each E/M visit if only providing 1-3 visits.

As per ACOG and AMA guidelines, The antepartum care only codes 59425 or 59426 should be reported as described below,

• A single claim submission of CPT code 59425 or 59426 for the antepartum care only, excluding the confirmatory visit that may be reported and separately reimbursed when the antepartum record has not been initiated.
  
• The units reported should be one.
  
• The dates reported should be the range of time covered,
  

E.g. If the patient had a total of 4-6 antepartum visits then the physician should report CPT code 59425 with the from and to dates for which the services occurred.

• CPT 59425 and 59426 – These codes must not be billed together by the same provider for the same beneficiary, during the same pregnancy.
  
• Pregnancy related E/M office visits must not be billed in conjunction with code 59425 or 59426 by the same provider for the same beneficiary, during the same pregnancy.

B. Delivery services only

The following are the delivery CPT codes,

CPT 59409 – Vaginal delivery only (with or without episiotomy and/or forceps)

CPT 59514 – Cesarean delivery only

CPT 59612 – Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps)

CPT 59620 – Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery

The delivery only codes should be reported by the same group physician for a single gestation when,

• The total OB package is not provided to the patient by the same physician or group practice.
  
• Only the delivery component of the maternity care is provided and the postpartum care is performed by another physician or group of physicians.
  

Services included in the delivery services

      As CPT and ACOG guidelines the following services are included in the delivery services codes and shouldn’t be reported separately.

• Admission to the hospital,
  
• The admission history and physical examination,
  
• Management of uncomplicated labor, vaginal delivery (with or without episiotomy, with or without forceps), or cesarean delivery, external and internal fetal monitoring provided by the attending physician
  
• Intravenous induction of labor via oxytocin (CPT code 96365-96367)
  
• Delivery of the placenta, any method
  
• Repair of first or second degree lacerations
  

Insertion of cervical dilator (CPT 59200) to be included if performed on the same date of delivery.

Reporting of third and fourth degree lacerations should be identified by appending modifier 22 to the global OB code (CPT codes 59400 and 59610) or delivery only code (CPT codes 59409, 59410, 59612 and 59614)

Claims submitted with modifier 22 must include medical record documentation which supports the use of modifier.

C. Delivery only including postpartum care

If the same individual or Same group physician provided the delivery care and postpartum care, in these instances few CPT code has encompass both of these services, The following are CPT defined delivery and postpartum care.

CPT 59410 – Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care

CPT 59515 – Cesarean delivery only; including postpartum care 

CPT 59614 – Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care

CPT 59622 – Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care

Services included in the delivery only including postpartum care services

• Hospital visits related to the delivery during the delivery confinement
  
• Uncomplicated outpatient visits related to the pregnancy
  
• Discussion of contraception
  

D. Postpartum Care Only

The following is the CPT defined postpartum care only,

CPT 59430 – Postpartum care only (separate procedure)

Services included in the postpartum care

• Uncomplicated outpatient visits related to the pregnancy
  
• Discussion of contraception
  

Services Excluded in the postpartum care

• E/M of problems or complications related to the pregnancy
  

Billing Guidelines

The postpartum care only should be reported by the same group physician provides the patient with services of postpartum care only.

If a physician provides any component of antepartum along with postpartum care, but does not perform the delivery, then the services should be itemized by using the appropriate counterpart care code and postpartum care code.


REFERENCES:

http://www.uhccommunityplan.com/content/dam/communityplan/healthcareprofessionals/reimbursementpolicies/R0064-ObstetricalServicesPolicy.pdf

http://www.acog.org/Resources-And-Publications

https://www.pacificsource.com/searchresults.aspx?searchtext=59400

https://www.oxhp.com/secure/policy/obstetrical_policy.pdf

ICD 10 CM (Y Series)

Y900	Blood alcohol level of less than 20 mg/100 ml
Y901	Blood alcohol level of 20-39 mg/100 ml
Y902	Blood alcohol level of 40-59 mg/100 ml
Y903	Blood alcohol level of 60-79 mg/100 ml
Y904	Blood alcohol level of 80-99 mg/100 ml
Y905	Blood alcohol level of 100-119 mg/100 ml
Y906	Blood alcohol level of 120-199 mg/100 ml
Y907	Blood alcohol level of 200-239 mg/100 ml
Y908	Blood alcohol level of 240 mg/100 ml or more
Y909	Presence of alcohol in blood, level not specified
Y92	Place of occurrence of the external cause
Y920	Non-institutional (private) residence as the place of occurrence of the external cause
Y9200	Unspecified non-institutional (private) residence as the place of occurrence of the external cause
Y92000	Kitchen of unspecified non-institutional (private) residence as  the place of occurrence of the external cause
Y92001	Dining room of unspecified non-institutional (private) residence as the place of occurrence of the external cause
Y92002	Bathroom of unspecified non-institutional (private) residence single-family (private) house as the place of occurrence of the external cause
Y92003	Bedroom of unspecified non-institutional (private) residence as the place of occurrence of the external cause
Y92007	Garden or yard of unspecified non-institutional (private) residence as the place of occurrence of the external cause
Y92008	Other place in unspecified non-institutional (private) residence as the place of occurrence of the external cause
Y92009	Unspecified place in unspecified non-institutional (private) residence as the place of occurrence of the external cause
Y9201	Single-family non-institutional (private) house as the place of occurrence of the external cause
Y92010	Kitchen of single-family (private) house as the place of occurrence of the external cause
Y92011	Dining room of single-family (private) house as the place of occurrence of the external cause
Y92012	Bathroom of single-family (private) house as the place of occurrence of the external cause
Y92013	Bedroom of single-family (private) house as the place of occurrence of the external cause
Y92014	Private driveway to single-family (private) house as the place of occurrence of the external cause
Y92015	Private garage of single-family (private) house as the place of occurrence of the external cause
Y92016	Swimming-pool in single-family (private) house or garden as the place of occurrence of the external cause
Y92017	Garden or yard in single-family (private) house as the place of occurrence of the external cause
Y92018	Other place in single-family (private) house as the place of occurrence of the external cause
Y92019	Unspecified place in single-family (private) house as the place of occurrence of the external cause
Y9202	Mobile home as the place of occurrence of the external cause
Y92020	Kitchen in mobile home as the place of occurrence of the external cause
Y92021	Dining room in mobile home as the place of occurrence of the external cause
Y92022	Bathroom in mobile home as the place of occurrence of the external cause
Y92023	Bedroom in mobile home as the place of occurrence of the external cause
Y92024	Driveway of mobile home as the place of occurrence of the external cause
Y92025	Garage of mobile home as the place of occurrence of the external cause
Y92026	Swimming-pool of mobile home as the place of occurrence of the external cause
Y92027	Garden or yard of mobile home as the place of occurrence of the external cause
Y92028	Other place in mobile home as the place of occurrence of the external cause
Y92029	Unspecified place in mobile home as the place of occurrence of the external cause
Y9203	Apartment as the place of occurrence of the external cause
Y92030	Kitchen in apartment as the place of occurrence of the external cause
Y92031	Bathroom in apartment as the place of occurrence of the external cause
Y92032	Bedroom in apartment as the place of occurrence of the external cause
Y92038	Other place in apartment as the place of occurrence of the external cause
Y92039	Unspecified place in apartment as the place of occurrence of the external cause
Y9204	Boarding-house as the place of occurrence of the external cause
Y92040	Kitchen in boarding-house as the place of occurrence of the external cause
Y92041	Bathroom in boarding-house as the place of occurrence of the external cause
Y92042	Bedroom in boarding-house as the place of occurrence of the external cause
Y92043	Driveway of boarding-house as the place of occurrence of the external cause
Y92044	Garage of boarding-house as the place of occurrence of the external cause
Y92045	Swimming-pool of boarding-house as the place of occurrence of the external cause
Y92046	Garden or yard of boarding-house as the place of occurrence of the external cause
Y92048	Other place in boarding-house as the place of occurrence of the external cause
Y92049	Unspecified place in boarding-house as the place of occurrence of the external cause
Y9209	Other non-institutional residence as the place of occurrence of the external cause
Y92090	Kitchen in other non-institutional residence as the place of occurrence of the external cause
Y92091	Bathroom in other non-institutional residence as the place of occurrence of the external cause
Y92092	Bedroom in other non-institutional residence as the place of occurrence of the external cause
Y92093	Driveway of other non-institutional residence as the place of occurrence of the external cause
Y92094	Garage of other non-institutional residence as the place of occurrence of the external cause
Y92095	Swimming-pool of other non-institutional residence as the place of occurrence of the external cause
Y92096	Garden or yard of other non-institutional residence as the place of occurrence of the external cause
Y92098	Other place in other non-institutional residence as the place of occurrence of the external cause
Y92099	Unspecified place in other non-institutional residence as the place of occurrence of the external cause
Y921	Institutional (nonprivate) residence as the place of occurrence of the external cause
Y9210	Unspecified residential institution as the place of occurrence of the external cause
Y9211	Children's home and orphanage as the place of occurrence of the external cause
Y92110	Kitchen in children's home and orphanage as the place of occurrence of the external cause
Y92111	Bathroom in children's home and orphanage as the place of occurrence of the external cause
Y92112	Bedroom in children's home and orphanage as the place of occurrence of the external cause
Y92113	Driveway of children's home and orphanage as the place of occurrence of the external cause
Y92114	Garage of children's home and orphanage as the place of occurrence of the external cause
Y92115	Swimming-pool of children's home and orphanage as the place of occurrence of the external cause
Y92116	Garden or yard of children's home and orphanage as the place of occurrence of the external cause
Y92118	Other place in children's home and orphanage as the place of occurrence of the external cause
Y92119	Unspecified place in children's home and orphanage as the place of occurrence of the external cause
Y9212	Nursing home as the place of occurrence of the external cause
Y92120	Kitchen in nursing home as the place of occurrence of the external cause
Y92121	Bathroom in nursing home as the place of occurrence of the external cause
Y92122	Bedroom in nursing home as the place of occurrence of the external cause
Y92123	Driveway of nursing home as the place of occurrence of the external cause
Y92124	Garage of nursing home as the place of occurrence of the external cause
Y92125	Swimming-pool of nursing home as the place of occurrence of the external cause
Y92126	Garden or yard of nursing home as the place of occurrence of the external cause
Y92128	Other place in nursing home as the place of occurrence of the external cause
Y92129	Unspecified place in nursing home as the place of occurrence of the external cause
Y9213	Military base as the place of occurrence of the external cause
Y92130	Kitchen on military base as the place of occurrence of the external cause
Y92131	Mess hall on military base as the place of occurrence of the external cause
Y92133	Barracks on military base as the place of occurrence of the external cause
Y92135	Garage on military base as the place of occurrence of the external cause
Y92136	Swimming-pool on military base as the place of occurrence of the external cause
Y92137	Garden or yard on military base as the place of occurrence of the external cause
Y92138	Other place on military base as the place of occurrence of the external cause
Y92139	Unspecified place military base as the place of occurrence of the external cause
Y9214	Prison as the place of occurrence of the external cause
Y92140	Kitchen in prison as the place of occurrence of the external cause
Y92141	Dining room in prison as the place of occurrence of the external cause
Y92142	Bathroom in prison as the place of occurrence of the external cause
Y92143	Cell of prison as the place of occurrence of the external cause
Y92146	Swimming-pool of prison as the place of occurrence of the external cause
Y92147	Courtyard of prison as the place of occurrence of the external cause
Y92148	Other place in prison as the place of occurrence of the external cause
Y92149	Unspecified place in prison as the place of occurrence of the external cause
Y9215	Reform school as the place of occurrence of the external cause
Y92150	Kitchen in reform school as the place of occurrence of the external cause
Y92151	Dining room in reform school as the place of occurrence of the external cause
Y92152	Bathroom in reform school as the place of occurrence of the external cause
Y92153	Bedroom in reform school as the place of occurrence of the external cause
Y92154	Driveway of reform school as the place of occurrence of the external cause
Y92155	Garage of reform school as the place of occurrence of the external cause
Y92156	Swimming-pool of reform school as the place of occurrence of the external cause
Y92157	Garden or yard of reform school as the place of occurrence of the external cause
Y92158	Other place in reform school as the place of occurrence of the external cause
Y92159	Unspecified place in reform school as the place of occurrence of the external cause
Y9216	School dormitory as the place of occurrence of the external cause
Y92160	Kitchen in school dormitory as the place of occurrence of the external cause
Y92161	Dining room in school dormitory as the place of occurrence of the external cause
Y92162	Bathroom in school dormitory as the place of occurrence of the external cause
Y92163	Bedroom in school dormitory as the place of occurrence of the external cause
Y92168	Other place in school dormitory as the place of occurrence of the external cause
Y92169	Unspecified place in school dormitory as the place of occurrence of the external cause
Y9219	Other specified residential institution as the place of occurrence of the external cause
Y92190	Kitchen in other specified residential institution as the place of occurrence of the external cause
Y92191	Dining room in other specified residential institution as the place of occurrence of the external cause
Y92192	Bathroom in other specified residential institution as the place of occurrence of the external cause
Y92193	Bedroom in other specified residential institution as the place of occurrence of the external cause
Y92194	Driveway of other specified residential institution as the place of occurrence of the external cause
Y92195	Garage of other specified residential institution as the place of occurrence of the external cause
Y92196	Pool of other specified residential institution as the place of occurrence of the external cause
Y92197	Garden or yard of other specified residential institution as the place of occurrence of the external cause
Y92198	Other place in other specified residential institution as the place of occurrence of the external cause
Y92199	Unspecified place in other specified residential institution as the place of occurrence of the external cause
Y922	School, other institution and public administrative area as the place of occurrence of the external cause
Y9221	School (private) (public) (state) as the place of occurrence of the external cause
Y92210	Daycare center as the place of occurrence of the external cause
Y92211	Elementary school as the place of occurrence of the external cause
Y92212	Middle school as the place of occurrence of the external cause
Y92213	High school as the place of occurrence of the external cause
Y92214	College as the place of occurrence of the external cause
Y92215	Trade school as the place of occurrence of the external cause
Y92218	Other school as the place of occurrence of the external cause
Y92219	Unspecified school as the place of occurrence of the external cause
Y9222	Religious institution as the place of occurrence of the external cause
Y9223	Hospital as the place of occurrence of the external cause
Y92230	Patient room in hospital as the place of occurrence of the external cause
Y92231	Patient bathroom in hospital as the place of occurrence of the external cause
Y92232	Corridor of hospital as the place of occurrence of the external cause
Y92233	Cafeteria of hospital as the place of occurrence of the external cause
Y92234	Operating room of hospital as the place of occurrence of the external cause
Y92238	Other place in hospital as the place of occurrence of the external cause
Y92239	Unspecified place in hospital as the place of occurrence of the external cause
Y9224	Public administrative building as the place of occurrence of the external cause
Y92240	Courthouse as the place of occurrence of the external cause
Y92241	Library as the place of occurrence of the external cause
Y92242	Post office as the place of occurrence of the external cause
Y92243	City hall as the place of occurrence of the external cause
Y92248	Other public administrative building as the place of occurrence of the external cause
Y9225	Cultural building as the place of occurrence of the external cause
Y92250	Art Gallery as the place of occurrence of the external cause
Y92251	Museum as the place of occurrence of the external cause
Y92252	Music hall as the place of occurrence of the external cause
Y92253	Opera house as the place of occurrence of the external cause
Y92254	Theater (live) as the place of occurrence of the external cause
Y92258	Other cultural public building as the place of occurrence of the external cause
Y9226	Movie house or cinema as the place of occurrence of the external cause
Y9229	Other specified public building as the place of occurrence of the external cause
Y923	Sports and athletics area as the place of occurrence of the external cause
Y9231	Athletic court as the place of occurrence of the external cause
Y92310	Basketball court as the place of occurrence of the external cause
Y92311	Squash court as the place of occurrence of the external cause
Y92312	Tennis court as the place of occurrence of the external cause
Y92318	Other athletic court as the place of occurrence of the external cause
Y9232	Athletic field as the place of occurrence of the external cause
Y92320	Baseball field as the place of occurrence of the external cause
Y92321	Football field as the place of occurrence of the external cause
Y92322	Soccer field as the place of occurrence of the external cause
Y92328	Other athletic field as the place of occurrence of the external cause
Y9233	Skating rink as the place of occurrence of the external cause
Y92330	Ice skating rink (indoor) (outdoor) as the place of occurrence of the external cause
Y92331	Roller skating rink as the place of occurrence of the external cause
Y9234	Swimming pool (public) as the place of occurrence of the external cause
Y9239	Other specified sports and athletic area as the place of occurrence of the external cause
Y924	Street , highway and other paved roadways as the place of occurrence of the external cause
Y9241	Street and highway as the place of occurrence of the external cause
Y92410	Unspecified street and highway as the place of occurrence of the external cause
Y92411	Interstate highway as the place of occurrence of the external cause
Y92412	Parkway as the place of occurrence of the external cause
Y92413	State road as the place of occurrence of the external cause
Y92414	Local residential or business street as the place of occurrence of the external cause
Y92415	Exit ramp or entrance ramp of street or highway as the place of occurrence of the external cause
Y9248	Other paved roadways as the place of occurrence of the external cause
Y92480	Sidewalk as the place of occurrence of the external cause
Y92481	Parking lot as the place of occurrence of the external cause
Y92482	Bike path as the place of occurrence of the external cause
Y92488	Other paved roadways as the place of occurrence of the external cause
Y925	Trade and service area as the place of occurrence of the external cause
Y9251	Private commercial establishments as the place of occurrence of the external cause
Y92510	Bank as the place of occurrence of the external cause
Y92511	Restaurant or cafe as the place of occurrence of the external cause
Y92512	Supermarket, store or market as the place of occurrence of the external cause
Y92513	Shop (commercial) as the place of occurrence of the external cause
Y9252	Service areas as the place of occurrence of the external cause
Y92520	Airport as the place of occurrence of the external cause
Y92521	Bus station as the place of occurrence of the external cause
Y92522	Railway station as the place of occurrence of the external cause
Y92523	Highway rest stop as the place of occurrence of the external cause
Y92524	Gas station as the place of occurrence of the external cause
Y9253	Ambulatory health services establishments as the place of occurrence of the external cause
Y92530	Ambulatory surgery center as the place of occurrence of the external cause
Y92531	Health care provider office as the place of occurrence of the external cause
Y92532	Urgent care center as the place of occurrence of the external cause
Y92538	Other ambulatory health services establishments as the place of occurrence of the external cause
Y9259	Other trade areas as the place of occurrence of the external cause
Y926	Industrial and construction area as the place of occurrence of the external cause
Y9261	Building [any] under construction as the place of occurrence of the external cause
Y9262	Dock or shipyard as the place of occurrence of the external cause
Y9263	Factory as the place of occurrence of the external cause
Y9264	Mine or pit as the place of occurrence of the external cause
Y9265	Oil rig as the place of occurrence of the external cause
Y9269	Other specified industrial and construction area as the place of occurrence of the external cause
Y927	Farm as the place of occurrence of the external cause
Y9271	Barn as the place of occurrence of the external cause
Y9272	Chicken coop as the place of occurrence of the external cause
Y9273	Farm field as the place of occurrence of the external cause
Y9274	Orchard as the place of occurrence of the external cause
Y9279	Other farm location as the place of occurrence of the external cause
Y928	Other places as the place of occurrence of the external cause
Y9281	Transport vehicle as the place of occurrence of the external cause
Y92810	Car as the place of occurrence of the external cause
Y92811	Bus as the place of occurrence of the external cause
Y92812	Truck as the place of occurrence of the external cause
Y92813	Airplane as the place of occurrence of the external cause
Y92814	Boat as the place of occurrence of the external cause
Y92815	Train as the place of occurrence of the external cause
Y92816	Subway car as the place of occurrence of the external cause
Y92818	Other transport vehicle as the place of occurrence of the external cause
Y9282	Wilderness area
Y92820	Desert as the place of occurrence of the external cause
Y92821	Forest as the place of occurrence of the external cause
Y92828	Other wilderness area as the place of occurrence of the external cause
Y9283	Recreation area as the place of occurrence of the external cause
Y92830	Public park as the place of occurrence of the external cause
Y92831	Amusement park as the place of occurrence of the external cause
Y92832	Beach as the place of occurrence of the external cause
Y92833	Campsite as the place of occurrence of the external cause
Y92834	Zoological garden (Zoo) as the place of occurrence of the external cause
Y92838	Other recreation area as the place of occurrence of the external cause
Y9284	Military training ground as the place of occurrence of the external cause
Y9285	Railroad track as the place of occurrence of the external cause
Y9286	Slaughter house as the place of occurrence of the external cause
Y9289	Other specified places as the place of occurrence of the external cause
Y929	Unspecified place or not applicable
Y93	Activity codes
Y930	Activities involving walking and running
Y9301	Activity, walking, marching and hiking
Y9302	Activity, running
Y931	Activities involving water and water craft
Y9311	Activity, swimming
Y9312	Activity, springboard and platform diving
Y9313	Activity, water polo
Y9314	Activity, water aerobics and water exercise
Y9315	Activity, underwater diving and snorkeling
Y9316	Activity, rowing, canoeing, kayaking, rafting and tubing
Y9317	Activity, water skiing and wake boarding
Y9318	Activity, surfing, windsurfing and boogie boarding
Y9319	Activity, other involving water and watercraft
Y932	Activities involving ice and snow
Y9321	Activity, ice skating
Y9322	Activity, ice hockey
Y9323	Activity, snow (alpine) (downhill) skiing, snow boarding, sledding, tobogganing and snow tubing
Y9324	Activity, cross country skiing
Y9329	Activity, other involving ice and snow
Y933	Activities involving climbing, rappelling and jumping off
Y9331	Activity, mountain climbing, rock climbing and wall climbing
Y9332	Activity, rappelling
Y9333	Activity, BASE jumping
Y9334	Activity, bungee jumping
Y9335	Activity, hang gliding
Y9339	Activity, other involving climbing, rappelling and jumping off
Y934	Activities involving dancing and other rhythmic movement
Y9341	Activity, dancing
Y9342	Activity, yoga
Y9343	Activity, gymnastics
Y9344	Activity, trampolining
Y9345	Activity, cheerleading
Y9349	Activity, other involving dancing and other rhythmic movements
Y935	Activities involving other sports and athletics played individually
Y9351	Activity, roller skating (inline) and skateboarding
Y9352	Activity, horseback riding
Y9353	Activity, golf
Y9354	Activity, bowling
Y9355	Activity, bike riding
Y9356	Activity, jumping rope
Y9357	Activity, non-running track and field events
Y9359	Activity, other involving other sports and athletics played individually
Y936	Activities involving other sports and athletics played as a team or group
Y9361	Activity, american tackle football
Y9362	Activity, american flag or touch football
Y9363	Activity, rugby
Y9364	Activity, baseball
Y9365	Activity, lacrosse and field hockey
Y9366	Activity, soccer
Y9367	Activity, basketball
Y9368	Activity, volleyball (beach) (court)
Y936A	Activity, physical games generally associated with school recess, summer camp and children
Y9369	Activity, other involving other sports and athletics played as a team or group
Y937	Activities involving other specified sports and athletics
Y9371	Activity, boxing
Y9372	Activity, wrestling
Y9373	Activity, racquet and hand sports
Y9374	Activity, frisbee
Y9375	Activity, martial arts
Y9379	Activity, other specified sports and athletics
Y93A	Activities involving other cardiorespiratory exercise
Y93A1	Activity, exercise machines primarily for cardiorespiratory conditioning
Y93A2	Activity, calisthenics
Y93A3	Activity, aerobic and step exercise
Y93A4	Activity, circuit training
Y93A5	Activity, obstacle course
Y93A6	Activity, grass drills
Y93A9	Activity, other involving cardiorespiratory exercise
Y93B	Activities involving other muscle strengthening exercises
Y93B1	Activity, exercise machines primarily for muscle strengthening
Y93B2	Activity, push-ups, pull-ups, sit-ups
Y93B3	Activity, free weights
Y93B4	Activity, pilates
Y93B9	Activity, other involving muscle strengthening exercises
Y93C	Activities involving computer technology and electronic devices
Y93C1	Activity, computer keyboarding
Y93C2	Activity, hand held interactive electronic device
Y93C9	Activity, other involving computer technology and electronic devices
Y93D	Activities involving arts and handcrafts
Y93D1	Activity, knitting and crocheting
Y93D2	Activity, sewing
Y93D3	Activity, furniture building and finishing
Y93D9	Activity, other involving arts and handcrafts
Y93E	Activities involving personal hygiene and interior property and clothing maintenance
Y93E1	Activity, personal bathing and showering
Y93E2	Activity, laundry
Y93E3	Activity, vacuuming
Y93E4	Activity, ironing
Y93E5	Activity, floor mopping and cleaning
Y93E6	Activity, residential relocation
Y93E8	Activity, other personal hygiene
Y93E9	Activity, other interior property and clothing maintenance
Y93F	Activities involving caregiving
Y93F1	Activity, caregiving, bathing
Y93F2	Activity, caregiving, lifting
Y93F9	Activity, other caregiving
Y93G	Activities involving food preparation, cooking and grilling
Y93G1	Activity, food preparation and clean up
Y93G2	Activity, grilling and smoking food
Y93G3	Activity, cooking and baking
Y93G9	Activity, other involving cooking and grilling
Y93H	Activities involving exterior property and land maintenance, building and construction
Y93H1	Activity, digging, shoveling and raking
Y93H2	Activity, gardening and landscaping
Y93H3	Activity, building and construction
Y93H9	Activity, other involving exterior property and land maintenance, building and construction
Y93I	Activities involving roller coasters and other types of external motion
Y93I1	Activity, roller coaster riding
Y93I9	Activity, other involving external motion
Y93J	Activities involving playing musical instrument
Y93J1	Activity, piano playing
Y93J2	Activity, drum and other percussion instrument playing
Y93J3	Activity, string instrument playing
Y93J4	Activity, winds and brass instrument playing
Y93K	Activities involving animal care
Y93K1	Activity, walking an animal
Y93K2	Activity, milking an animal
Y93K3	Activity, grooming and shearing an animal
Y93K9	Activity, other involving animal care
Y938	Activities, other specified
Y9381	Activity, refereeing a sports activity
Y9382	Activity, spectator at an event
Y9383	Activity, rough housing and horseplay
Y9384	Activity, sleeping
Y9389	Activity, other specified
Y939	Activity, unspecified
Y95	Nosocomial condition
Y99	External cause status
Y990	Civilian activity done for income or pay
Y991	Military activity
Y992	Volunteer activity
Y998	Other external cause status
Y999	Unspecified external cause status