MVA Whiplash is defined as a sudden extension of the cervical spine (backward movement of the neck) and flexion (forward movement of the neck). This type of trauma is also referred to as a cervical acceleration-deceleration (CAD) injury. Rear-end or side-impact motor vehicle collisions are the number one cause of whiplash with injury to the muscles, ligaments, tendons, joints, and discs of the cervical spine.
The physical exam combined with the imaging studies help determine the severity or grade of the injury. There is more than one way to assign a grade to a patient’s whiplash. Here are two examples of the more commonly used models used to classify or grade whiplash injuries:
Croft Guidelines
Grade I: Minimal – No limitation of motion, no ligamentous injury, no neurological findings
Grade II: Slight – Slight limitation of motion, no ligamentous injury, no neurologic findings
Grade III: Moderate – Limitation of motion, ligamentous instability, neurologic symptoms present
Grade IV: Moderate-to-Severe – Limitation of motion, some ligamentous injury, neurological symptoms, fracture or disc derangement
Quebec Whiplash Classification
Grade 0: No complaint or physical sign
Grade I: Neck complaint of pain, stiffness or tenderness, no physical signs
Grade II: Neck pain and musculoskeletal signs
Grade III: Neck pain and neurological signs
Grade IV: Neck pain and fracture or dislocation
ICD codes refer to diagnoses and CPT codes refer to medical treatments. Generally speaking, ICD code ICD-10-CM S13.4 refers to cervical strains and for the CPT code one would need to have a specific treatment such as 97110 for therapy exercises or 97140 for therapeutic traction or manipulation.
The diagnosis of whiplash remains clinical. The mechanism of injury must be elicited. The clinical syndrome of whiplash and WAD includes neck pain or stiffness, arm pain and paresthesias, temporomandibular dysfunction, headache, visual disturbances, memory and concentration problems, and psychological distress. There are no specific neuropsychological studies or electrophysiological tests that can diagnose whiplash injury.
A wide variety of psychosocial symptoms may be associated with whiplash including depression, anger, fear, anxiety, and hypochondriasis. A so-called whiplash profile has been described, which includes high scores on subscales of somatization, depression, and obsessive-compulsive behavior in patients with WAD. Whiplash: diagnosis, treatment, and associated injuries, Yadla, S., Ratliff, J.K. & Harrop, J.S. Curr Rev Musculoskelet Med (2008).
McCormick Law Office attorneys collect the medical records from the treating physicians and other healthcare providers in order to focus in on the diagnosis in a MVA whiplash collision case. The label the physician uses for diagnostic purposes may not be as important as the symptoms documented and the course of treatment engaged to treat those car accident symptoms.
