Matrix of E-code Groupings

Table 1. Recommended framework of E-code groupings for presenting injury mortality and morbidity data (August 10, 2011)

This matrix contains the ICD-9 external-cause-of-injury codes used for coding of injury mortality data and additional ICD-9-CM external-cause-of-injury codes, designated in bold, only used for coding of injury morbidity data. In addition, a list of ICD-9-CM external-cause-of-injury codes that have been added since 1994 along with their descriptors is appended to the matrix.

¹Includes legal intervention (E970-E978) and operations of war (E990-E999).
²Three 4th-digit codes (.4 [occupant of streetcar], .5 [rider of animal], .8 [other specified person]) are not presented separately because of small numbers. However, because they are included in the overall motor vehicle traffic category, the sum of these categories can be derived by subtraction.
³Codes in bold are for morbidity coding only. For details see table 2.
⁴E849 (place of occurrence) has been excluded from the matrix. For mortality coding, an ICD-9 E849 code does not exist. For morbidity coding, an ICD-9-CM E849 code should never be first-listed E code and should only appear as an additional code to specify the place of occurrence of the injury incident.

Note: ICD-9 E codes for coding underlying cause of death apply to injury-related death data from 1979 through 1998. Then there is a new ICD-10 external cause of injury matrix that applies to death data from 1999 and after. This can be found on the National Center for Health Statistics website.

About the framework.

ICD-10 External-Cause-of-Injury-Code Matrix for Presenting Injury Mortality Data (NCHS)

Table 2. New ICD-9-CM external-cause-of-injury codes (E-codes) implemented by year since October 1994

Important Note: New E codes and revised E codes were implemented in October of each year listed. In most instances, the expanded categories (i.e., adding a new fourth digit) were previously classified in other more broadly defined E codes. Expansions of these categories allow data capture at a detailed level. A major change was made on October 1, 2001 to help classify cases that involve "a fall followed by a struck by/against" and "a struck by/against followed by a fall." This brought about major revisions to inclusion and exclusion criteria for E888 and E917 codes. The new codes and revised E888 and E917 codes are listed above. Note that E917.1, E917.2 and E917.9 have substantially revised definitions. On October 1, 2002, E codes were added to capture “fall (non-motorized) scooter” and to capture injuries associated with paintball guns. Note that there is not a new specific code for paintball gun assault. This is because there were no more available assault codes at the 4th digit. Also, terrorism codes were added. On October 1, 2003, E928.4 (i.e., external constriction caused by hair) was added to capture injuries, particularly in infants, where the hair on a finger or toe can lead to circulation problems and possibly gangrene. Also, E928.5 (i.e., external constriction caused by other object) was added to capture injuries due to other objects, such as a wedding ring that may become imbedded in skin. This is sometimes seen in cases where someone gained weight and didn't remove a ring from their finger.

On October 1, 2013, ICD-10-CM will be implemented in the United States for classification and coding of morbidity data. CDC is working on developing a new external-cause-of-injury matrix and crosswalk from ICD-9-CM to ICD-10-CM. This is a challenging effort because of much more specificity and many more codes in ICD-10-CM compared to ICD-9-CM. For example, ICD-9-CM has about 14,000 codes compared to ICD-10-CM which has about 68,000 codes (i.e., including diagnosis and external cause codes). Also, ICD-10-CM does not include external cause codes for most poisonings and toxic effects. Poisoning and toxic effects are specified using T codes with intent indicated using an addition digit on the code. (If you want to explore the new ICD-10-CM code sets, go to www.cdc.gov/nchs/icd/icd10cm.htm.) This was done in order to provide much more specificity about the substance involved in a poisoning incident. The new ICD-10-CM will go through extensive review prior to release so it will not be ready for a year or so. CDC will keep our partners and colleagues informed regarding progress toward completing this task.