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W19 ICD-10-CM Code: Unspecified fall

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

W19

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Unspecified fall

Unspecified fall

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

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Code Book Path

Official
W1Slipping, tripping, stumbling and falls (W00-W19)
W19Unspecified fall

Inclusion Terms

Official
  • Accidental fall NOS

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for W19 in this effective period.

Related Child Codes

Official

ICD-10-CM does not list child codes under W19 for this display context.

Includes

Official

ICD-10-CM does not list Includes notes for W19 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for W19 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for W19 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for W19 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for W19 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.

What This Code Means

W19 is the ICD-10-CM diagnosis code for unspecified fall. W19 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).

Header codes like W19 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at W19's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for W19 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Code Hierarchy

W19Unspecified fall
W19Unspecified fall

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