Official Disability Guidelines
EFFECTS OF HEAT AND LIGHT
(3-character ICD10 T67)

T67  Effects of heat and light

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data11 days14 days
All absences2 days11 days

Return-To-Work "Best Practice" Guidelines
See T67.0

              Excludes1:
              erythema [dermatitis] ab igne (L59.0)
              malignant hyperpyrexia due to anesthesia (T88.3)
              radiation-related disorders of the skin and subcutaneous tissue (L55-L59)
              Excludes2:
              burns (T20-T31)
              sunburn (L55.-)
              sweat disorder due to heat (L74-L75)
              The appropriate 7th character is to be added to each code from category T67
              A - initial encounter
              D - subsequent encounter
              S - sequela

ICD-9 Code: 992
ODG Treatment Contents: ODG/TWC Index
ODG Treatment UR Advisor: 992
Other Links: Click below for detailed information on this condition:
Merck Manual | NGC | State Guidelines
Causality Likelihood:  21%
Hospital Costs: $11,547 (average of 4,144 cases)
Hospital Length Of Stay: 1.9 days
Common Procedure Codes (see ODG Treatment for auto approval codes): 36415 71010 71020 80048 80051 80053 81001 81003 82550 82553 82565 82947 84484 84520 85025 93005 93010 94760 99203 99282 99283 99284 99285
CM Triage: Level 1 (low touch), inflection point 11 days

Workers' Comp Costs per Claim (based on 1,905 claims)
Quartile25%50%75%Mean% no cost
Medical$317$557$950$8035%
Total$317$557$961$8175%

RTW Claims Data (Calendar-days away from work by decile)

10%20%30%40%50%60%70%80%90%100%Mean
991010111111121425412.84

   Integrated Disability Durations, in days*
   Median (mid-point)     2.0        Mean (average)        4.35
   Mode (most frequent)   1          Calculated rec.       2
                           Percent of Cases
                              (1330 cases)
                                                                      
 19.2                                                                 
                                                                      
      14.7                                                            
                                                                      
                                                                      
                                                                      
                                                                      
            4.3                                                       
                 2.8                      2.0  3.5  2.5               
                      1.4  1.0  0.7  0.5                 1.2  0.8  1.6
  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___
    1    2    3    4    5    6    7    8    9   10   11   12   13  14+
                               Days
   *CDC NHIS cases with no lost workdays: 584 (43.9%)

Impact on Total Absence: Prevalence 0.0080% of total lost workdays; Incidence 0.08 days per 100 workers

   Occupational Disability Durations, in days
   Median (mid-point)  2  -  Benchmark Indemnity Costs  $1,500
                           Percent of Cases
                              (1620 cases)
                                                                      
   42.0                                                               
                                                                      
                       30.9                                           
                                                                      
                                                                      
                                                                      
             15.4                                                     
                                                                      
                                  4.9                                 
                                            2.5       2.5       1.2   
  ______    ______    ______    ______    ______    ______    ______  
   1 day    2 days    3 to 5   6 to 10  11 to 20  21 to 30  31 or more
                           Range of Days

Impact on Occupational Absence: Prevalence 0.0367% of occupational lost workdays; Incidence 0.01 days per 100 workers

T67.0  Heatstroke and sunstroke

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data10 days14 days
All absences9 days13 days

Return-To-Work "Best Practice" Guidelines
Without hospitalization (depending on occupational evaluation): 1-2 days
With hospitalization: 10 days

Description: A life threatening condition resulting from prolonged exposure to extreme heat in which a person cannot sweat enough to lower body temperature.  Warning symptoms include headache, dizziness, weakness, confusion, or fatigue, as well as hot, flushed, dry skin.  Heart rate increases, body temperature rises, and there could be convulsions, collapse or damage to the brain, heart, liver, kidneys, or blood system.
              Heat apoplexy
              Heat pyrexia
              Siriasis
              Thermoplegia
              Use additional code(s) to identify any associated complications of heatstroke, such as:
              coma and stupor (R40.-)
              systemic inflammatory response syndrome (R65.1-)
ICD-9 Code(s): 992.0, V58.89, 909.4
ODG Treatment Contents: ODG/TWC Index
ODG Treatment UR Advisor: 992.0
Other Links: Click below for detailed information on this condition:
Merck Manual | NGC | State Guidelines
Causality Likelihood: Under 5%
Hospital Costs: $21,883 (average of 1,296 cases)
Hospital Length Of Stay: 4.6 days
CM Triage: Level 1 (low touch), inflection point 11 days

Workers' Comp Costs per Claim (based on 43 claims)
Quartile25%50%75%Mean% no cost
Medical$546$1,059$1,987$3,94915%
Total$644$1,114$4,226$4,52515%

RTW Claims Data (Calendar-days away from work by decile)

10%20%30%40%50%60%70%80%90%100%Mean
910101010111113142911.44

   Integrated Disability Durations, in days*
   Median (mid-point)     9.0        Mean (average)        7.21
   Mode (most frequent)   1          Calculated rec.       7
                           Percent of Cases
                              (115 cases)
                                                                      
 32.2                                                                 
                27.0                                                  
                                                                      
                                                                      
                                                                      
                                                                      
           10.4                                                       
                      7.0                                             
       3.5                                                            
                           0.9  0.9  0.0  0.0  0.9  0.0  0.0  0.0  0.0
  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___
    3    6    9   12   15   18   21   24   27   30   33   36   39  40+
                       Range of Days (up to)
   *CDC NHIS cases with no lost workdays: 20 (17.4%)

Impact on Total Absence: Prevalence 0.0016% of total lost workdays; Incidence 0.02 days per 100 workers

   Occupational Disability Durations, in days
   Median (mid-point)  3  -  Benchmark Indemnity Costs  $2,250
                              (150 cases)

Impact on Occupational Absence: Prevalence 0.0051% of occupational lost workdays

T67.1  Heat syncope

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data11 days14 days
All absences2 days11 days

Return-To-Work "Best Practice" Guidelines
Without hospitalization: 1 day
With hospitalization: 3 days

Description: Loss of consciousness as a result of high environmental temperatures.
              Heat collapse
ICD-9 Code(s): 992.1, V58.89, 909.4
ODG Treatment Contents: ODG/TWC Index
ODG Treatment UR Advisor: 992.1
Other Links: Click below for detailed information on this condition:
Merck Manual | NGC | State Guidelines
Causality Likelihood:  13%
Hospital Costs: $7,339 (average of 331 cases)
Hospital Length Of Stay: 1.6 days
CM Triage: Level 1 (low touch), inflection point 11 days

   Occupational Disability Durations, in days
   Median (mid-point)  2  -  Benchmark Indemnity Costs  $1,500
                              (40 cases)

Impact on Occupational Absence: Prevalence 0.0009% of occupational lost workdays

T67.2  Heat cramp

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data11 days14 days
All absences2 days11 days

Return-To-Work "Best Practice" Guidelines
Without hospitalization: 1 day
With hospitalization: 3 days

Description: Muscle contractions as a result of high environmental temperatures.
ICD-9 Code(s): 992.2, V58.89, 909.4
ODG Treatment Contents: ODG/TWC Index
ODG Treatment UR Advisor: 992.2
Other Links: Click below for detailed information on this condition:
Merck Manual | NGC | State Guidelines
Hospital Costs: $8,429
CM Triage: Level 1 (low touch), inflection point 11 days

T67.3  Heat exhaustion, anhydrotic

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data11 days14 days
All absences2 days11 days

Return-To-Work "Best Practice" Guidelines
Without hospitalization: 1 day
With hospitalization: 3 days

Description: Dehydration and lowered body temperature as a result of high environmental temperature.
              Heat prostration due to water depletion
              Excludes1:
              heat exhaustion due to salt depletion (T67.4)

ICD-9 Code(s): 992.3, V58.89, 909.4
ODG Treatment Contents: ODG/TWC Index
ODG Treatment UR Advisor: 992.3
Other Links: Click below for detailed information on this condition:
Merck Manual | NGC | State Guidelines
Hospital Costs: $6,633 (average of 588 cases)
Hospital Length Of Stay: 2.0 days
CM Triage: Level 1 (low touch), inflection point 11 days

T67.4  Heat exhaustion due to salt depletion

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data11 days14 days
All absences2 days11 days

Return-To-Work "Best Practice" Guidelines
Without hospitalization: 1 day
With hospitalization: 3 days

Description: Nausea, headache, and lowered body temperature as a result of high environmental temperatures.
              Heat prostration due to salt (and water) depletion
ICD-9 Code(s): 992.4, V58.89, 909.4
ODG Treatment Contents: ODG/TWC Index
Other Links: Click below for detailed information on this condition:
Merck Manual | NGC | State Guidelines
Causality Likelihood:  21%
Hospital Length Of Stay: 2.8 days
CM Triage: Level 1 (low touch), inflection point 11 days

T67.5  Heat exhaustion, unspecified

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data11 days16 days
All absences3 days10 days

Return-To-Work "Best Practice" Guidelines
Without hospitalization (day of presentation only): 0-1 days
With hospitalization: 1-5 days

Description: Condition caused by excessive exposure to heat, causing fatigue, low blood pressure, and sometimes collapse. Symptoms are a result of loss of fluids from heavy sweating and can also include weakness, anxiety, faintness, slow heartbeat, clammy cold skin, and/or confusion.
Other names: Heat collapse, Heat prostration
              Heat prostration NOS
ICD-9 Code(s): 992.5, V58.89, 909.4
ODG Treatment Contents: ODG/TWC Index
ODG Treatment UR Advisor: 992.5
Other Links: Click below for detailed information on this condition:
Merck Manual | NGC | State Guidelines
Causality Likelihood:  21%
Hospital Costs: $6,851 (average of 1,854 cases)
Hospital Length Of Stay: 2.0 days
Common Procedure Codes (see ODG Treatment for auto approval codes): 36415 71010 71020 80048 80051 80053 81001 81003 82550 82553 82565 82947 84484 84520 85025 93005 93010 94760 99203 99282 99283 99284 99285
CM Triage: Level 1 (low touch), inflection point 11 days

Workers' Comp Costs per Claim (based on 1,751 claims)
Quartile25%50%75%Mean% no cost
Medical$317$557$950$7514%
Total$317$557$961$7554%

RTW Claims Data (Calendar-days away from work by decile)

10%20%30%40%50%60%70%80%90%100%Mean
89910111113141636522.86

   Integrated Disability Durations, in days*
   Median (mid-point)     3.0        Mean (average)        6.41
   Mode (most frequent)   1          Calculated rec.       3
                           Percent of Cases
                              (1852 cases)
                                                                      
 25.3                                                                 
                                                                      
                                                                      
                                                                      
                                                                      
                                                                      
                      8.9                                             
       6.6                                                            
            5.0  5.0       4.2  3.1       2.7                      2.8
                                     1.9       1.6  1.5  1.1  1.2     
  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___
    1    2    3    4    5    6    7    8    9   10   11   12   13  14+
                               Days
   *CDC NHIS cases with no lost workdays: 543 (29.3%)

Impact on Total Absence: Prevalence 0.0207% of total lost workdays; Incidence 0.22 days per 100 workers

T67.6  Heat fatigue, transient

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data11 days14 days
All absences2 days11 days

Return-To-Work "Best Practice" Guidelines
1 day

Description: Mild exhaustion as a result of high environmental temperatures.
ICD-9 Code(s): 992.6, V58.89, 909.4
ODG Treatment Contents: ODG/TWC Index
ODG Treatment UR Advisor: 992.6
Other Links: Click below for detailed information on this condition:
Merck Manual | NGC | State Guidelines
Causality Likelihood: Over 80%
Hospital Costs: $5,147
Hospital Length Of Stay: 2.0 days
CM Triage: Level 1 (low touch), inflection point 11 days

   Occupational Disability Durations, in days
   Median (mid-point)  2  -  Benchmark Indemnity Costs  $1,500
                              (200 cases)

Impact on Occupational Absence: Prevalence 0.0045% of occupational lost workdays

T67.7  Heat edema

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data11 days14 days
All absences2 days11 days

Return-To-Work "Best Practice" Guidelines
1 day

Description: Fluid retention in body tissues as a result of high environmental temperatures.
ICD-9 Code(s): 992.7, V58.89, 909.4
ODG Treatment Contents: ODG/TWC Index
Other Links: Click below for detailed information on this condition:
Merck Manual | NGC | State Guidelines
CM Triage: Level 1 (low touch), inflection point 11 days

T67.8  Other effects of heat and light

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data11 days14 days
All absences2 days11 days

Return-To-Work "Best Practice" Guidelines
See T67.0

ICD-9 Code(s): 992.8, V58.89, 909.4
ODG Treatment Contents: ODG/TWC Index
ODG Treatment UR Advisor: 992.8
Other Links: Click below for detailed information on this condition:
Merck Manual | NGC | State Guidelines
Causality Likelihood: Over 80%
Hospital Costs: $6,130 (average of 75 cases)
Hospital Length Of Stay: 1.9 days
CM Triage: Level 1 (low touch), inflection point 11 days

   Occupational Disability Durations, in days
   Median (mid-point)  2  -  Benchmark Indemnity Costs  $1,500
                           Percent of Cases
                              (1120 cases)
                                                                      
   48.2                                                               
                                                                      
                                                                      
                       31.3                                           
                                                                      
                                                                      
                                                                      
             11.6                                                     
                                  6.3                                 
                                            1.8       0.0       0.0   
  ______    ______    ______    ______    ______    ______    ______  
   1 day    2 days    3 to 5   6 to 10  11 to 20  21 to 30  31 or more
                           Range of Days

Impact on Occupational Absence: Prevalence 0.0254% of occupational lost workdays

T67.9  Effect of heat and light, unspecified

Return-To-Work Summary Guidelines
DatasetMidrangeAt-Risk
Claims data10 days14 days
All absences2 days10 days

Return-To-Work "Best Practice" Guidelines
See T67.0

ICD-9 Code(s): 992.9, V58.89, 909.4
ODG Treatment Contents: ODG/TWC Index
Other Links: Click below for detailed information on this condition:
Merck Manual | NGC | State Guidelines
Causality Likelihood: Under 5%
CM Triage: Level 1 (low touch), inflection point 11 days

RTW Claims Data (Calendar-days away from work by decile)

10%20%30%40%50%60%70%80%90%100%Mean
8991010111113141511.00

   Integrated Disability Durations, in days*
   Median (mid-point)     2.0        Mean (average)        3.79
   Mode (most frequent)   1          Calculated rec.       2
                           Percent of Cases
                              (60 cases)
                                                                      
 33.3                                                                 
                                                                      
                                                                      
      23.3                                                            
                                                                      
                                                                      
                                                                      
            8.3  6.7                                                  
                                                                      
                      1.7  3.3  3.3  1.7  3.3  3.3  3.3  0.0  1.7  3.3
  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___
    1    2    3    4    5    6    7    8    9   10   11   12   13  14+
                               Days
   *CDC NHIS cases with no lost workdays: 2 (3.3%)

Impact on Total Absence: Prevalence 0.0005% of total lost workdays; Incidence 0.01 days per 100 workers

   Occupational Disability Durations, in days
   Median (mid-point)  2  -  Benchmark Indemnity Costs  $1,500
                           Percent of Cases
                              (90 cases)
                                                                      
   33.3      33.3                                                     
                                                                      
                                                                      
                       22.2                22.2                       
                                                                      
                                                                      
                                                                      
                                                                      
                                                                      
                                  0.0                 0.0       0.0   
  ______    ______    ______    ______    ______    ______    ______  
   1 day    2 days    3 to 5   6 to 10  11 to 20  21 to 30  31 or more
                           Range of Days

Impact on Occupational Absence: Prevalence 0.0020% of occupational lost workdays

ODG 2010 Work Loss Data Institute. All Rights Reserved.

CPT 2010 American Medical Association. All Rights Reserved.

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