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Injury Incident Date

Injury Incident Time

Incident Location ZIP or Postal Code

Incident Country

Incident State

Incident County

Incident City

Alcohol Use Indictor

Drug Use Test Results

Circumstances of Injury

  • Question: For circumstances of Injury for the non-burn, non-injury patients (e.g. the rash/skin infection conditions), what should be selected? The most likely selection seems to be either 'OTHER' or 'NOT KNOW/NOT RECORDED' or leaving the question blank. (Asked March 2024).

    • Answer: The best selection is "Other" and then enter the non-burn injury details in the dropdown box. You will also enter “Rash/Skin infection” in the Etiology of Non-Burn Injury section.

Non-Burn Injury

Primary ICD-10 External Cause Code

Location ICD-10 Code

Additional ICD-10 External Cause Code

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