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W16.211A ICD-10-CM Code: Fall in (into) filled bathtub causing drowning and submersion, initial encounter

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FY 2026 Apr update / External causes of morbidity (V00-Y99) / Slipping, tripping, stumbling and falls (W00-W19)

W16.211A

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Fall in (into) filled bathtub causing drowning and submersion, initial encounter

Fall in (into) filled bathtub causing drowning and submersion, initial encounter

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

Basket needed

Code Book Path

Official
W16.21Fall in (into) filled bathtub
W16.211Fall in (into) filled bathtub causing drowning and submersion
W16.211AFall in (into) filled bathtub causing drowning and submersion, initial encounter

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for W16.211A in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for W16.211A in this effective period.

Related Child Codes

Official
W16.211DFall in (into) filled bathtub causing drowning and submersion, subsequent encounter
W16.211SFall in (into) filled bathtub causing drowning and submersion, sequela

Includes

Official

ICD-10-CM does not list Includes notes for W16.211A in this effective period.

Excludes 1

Official
  • drowning and submersion while in filled bathtub without fall (W65)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for W16.211A in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for W16.211A in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for W16.211A in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is W16.211A an HCC code?

No. W16.211A is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

W16.211A is the ICD-10-CM diagnosis code for fall in (into) filled bathtub causing drowning and submersion, initial encounter. W16.211A sits in the ICD-10-CM chapter for external causes of morbidity (v00-y99), within the section covering slipping, tripping, stumbling and falls (w00-w19).

W16.211A is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

W16.211A is a billable ICD-10-CM code that can be reported on claims but does not currently contribute to a Medicare Advantage member's RAF score under any CMS risk adjustment model (V28, V24, ESRD, or RxHCC). Coders reviewing W16.211A should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for W16.211A sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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