ICD-10 Codes for Neck Injury While Playing Football
The appropriate ICD-10 codes for a neck injury sustained while playing football are S13.4XXA (cervical sprain, initial encounter) as the primary diagnosis code, W21.0XXA (struck by football, initial encounter) as the external cause code, and Y93.61 (activity, American football) as the activity code. 1
Primary Diagnosis Codes (S Codes)
The S codes document the specific injury to the neck. Common options include:
- S13.4XXA - Cervical sprain, initial encounter (most common for general neck strain)
- S13.0XXA - Traumatic rupture of cervical intervertebral disc, initial encounter
- S13.1XXA - Subluxation of cervical vertebrae, initial encounter
- S13.2XXA - Dislocation of cervical vertebrae, initial encounter
- S13.8XXA - Sprain of joints and ligaments of other parts of neck, initial encounter
- S14.0XXA - Concussion and edema of cervical spinal cord, initial encounter
- S14.1XXA - Other and unspecified injuries of cervical spinal cord, initial encounter
External Cause Codes (W Codes)
W codes document how the injury occurred:
- W21.0XXA - Struck by football, initial encounter
- W21.9XXA - Struck by other sports equipment, initial encounter
- W50.1XXA - Accidental hit or strike by another person, initial encounter
Activity Codes (Y Codes)
Y codes document what the patient was doing when injured:
- Y93.61 - Activity, American football
Coding Considerations
- The American Academy of Pediatrics recommends using this combination of S, W, and Y codes to comprehensively document sports-related neck injuries 1
- Proper coding helps track injury patterns and supports injury prevention efforts in youth sports 1
- Football is associated with a particularly high risk of neck injuries, especially during tackling or player-to-player contact 2, 3
Clinical Relevance
- Neck injuries in football commonly occur through head-to-head contact (39.5%), head-down tackling (28.9%), direct extremity-to-head contact (18.4%), and head-to-ground contact (13.2%) 3
- Defensive players are more likely to sustain neck injuries compared to offensive players, with defensive backs being the most commonly injured position 3
- The risk of catastrophic injuries to the head and neck in football is relatively low (0.19-1.78 per 100,000 participants) but appears higher in football than most other team sports 2
- Spear tackling (leading with the crown of the helmeted head) continues to be the predominant mechanism of injury causing quadriplegia 2
Documentation Tips
- Be specific about the anatomical location and nature of the injury
- Include information about the mechanism of injury (how it occurred)
- Document the activity being performed at the time of injury
- For initial encounters, use the 7th character "A" (e.g., S13.4XXA)
- For subsequent encounters, use the 7th character "D" (e.g., S13.4XXD)
- For sequelae, use the 7th character "S" (e.g., S13.4XXS)
Proper coding of neck injuries in football is essential for accurate medical documentation, appropriate reimbursement, and contributing to injury surveillance that may lead to improved safety measures in the sport.