Institut für Medizinische Informatik, Statistik und Epidemiologie

Informationsmanagement in der klinischen Forschung

Matthias Löbe

02.05.2019

Standards für Informationsmodelle und

Terminologien

2

Inhalt

1. Standards für Informationsmodelle• OpenEHR Archetypes

• CDISC ODM

• HL7 CDA

• HL7 FHIR

2. Terminologien• Ziele

• Beispiele für bedeutende medizinische Terminologien

• Probleme

Standards für Informationsmodelle in der klinischen Forschung

33

”Überblick”

44

Clinical Data Interchange Standards Consortium (CDISC)

• 1998 gegründete, nicht gewinnorientierte Organisation

• Entwickelt freie internationale Industriestandards für Erfassung,

Austausch, Auswertung und Archivierung von klinischen Daten

und Metadaten

• Zusammenarbeit mit Behörden und Industrie

• Die globale Anstrengung zur Standardisierung der Klinischen

Forschung

55

CDISC Standards

• CDISC Standards im Life

Cycle klinischer Standards

– Zeitversetzte Entwicklung

• ODM v1.1 erschien 04/02

• PRG v1 erschien 05/09

– Unabhängiges Arbeiten der

Teams

• Pragmatisch, jedoch zum

Teil inhomogen

– Zukünftig Zusammenführung

aller Standards unter ODM

66

ODM in Beziehung zu anderen CDISC-Standards

7

CDISC ODM

• Operational Data Model (ODM)

• Formatbezogener Standard auf XML Basis

– ODM = XML + „Interpreter mit Logiken“

• Zentraler Standard von CDISC zu Erfassung, Austausch und

Archivierung von Daten und Metadaten einer Studie

• ODM-Inhalte: Studiendaten, Patientendaten, Bedingungen mit

Fehlermeldungen, Codelisten, Datentypen, CrossChecks,

Referenzen auf externe Conceptsystems

88

Dokumentstruktur

99

ODM

• ODM-Dokumente sind

– Modularisierbar

– Versionierbar

– Mehrsprachig

– Erweiterbar (Vendorextension)

• Einsatz vom Definition-Referenz-Konzept

– Verringert Redundanz

– Erhöht Wartbarkeit

– Erhöht Flexibilität

– Erschwert Lesbarkeit

1010

Aufbau

• Modularisierbar

• Def-Ref-Konzept

• SDTM-Bezug

• mehrsprachig

11

ODM

• Versionierbar (Interpreter notwendig)

1212

ODM

• Bedingungen (Conditions): XPath, SQL, SAS, R, ...

1313

ODM

• Erweiterbar (Vendorextensions): Schema

1414

ODM

• Erweiterbar (Vendorextensions): Schema

1515

ODM

• Erweiterbar (Vendorextensions): Schema

1616

ODM

• Weitere Anwendungsmöglichkeiten

– Generierung von DB-Schemata für Studiendatenbanken

– Generierung von CRF/ eCRF

– Generierung von GUI

– Bibliotheken für wiederverwendbare Protokollmodule

– Langzeitarchivierung von Studien

– Austausch zwischen verschiedenen EDC-Systemen

• Siehe auch ODM-Export aus OpenClinica!

1717

Eli Lilly - ODM Library: I.SEX

Data Standard OID Name

SAS Field Name Datatype Length

SignificantDigits CodeListRef

Measurement Unit

CompletionRequired

Std00068 I.SEX Sex SEX integer 8 CL.MSTR_SEXRMD_93

X

Question: Sex

Description:

Sex captures a subject's or non-subject's chromosomal characteristic.

Alias: Context: SDTM 3.1.2 Name: SEX

Origin: CRF

18

CodeList: CL.MSTR_SEXRMD_93

OID Name SAS Format Name DataType Root Name Code Standard Number

CL.MSTR_SEXRMD_93

Master view of Sex (Std70051), includes '93' RMD

MSEXR integer SEX Std70051

Business Name: Sex

Description: Sex captures a subject's or non-subject's chromosomal characteristic.

Last Revision: 09SEP2011: Updated the Short Desc for code 93 from ‘Not Done’ to 'NOT DONE'. CR06241500 gb_nmd

CodeList Items:

Code Decode Rank Label CodeList Item Comment

1 Female F

2 Male M93 Not Done NOT DONE

18

• open Electronic Health Record

• umfassende Spezifikationen für die

logische Entwicklung von

elektronischen Gesundheitsakten (EGA)

• eingegangen in EN 13606

• kommerzielle Implementierungen vorhanden

Source: www.openEHR.org

openEHR Archetypes

19

„traditioneller Ansatz“

Domänen-

wissen

technische

EntwicklungAnwendungs-

system

Fachexperte Entwickler

openEHR

20

FachexperteEntwickler

Domänen-

wissentechnische

Entwicklung

Anwendungs-

system

openEHR

21

Information Wissen

Modell

Instanz

Informations-

modell

Information

Definitions-

sprache

Archetypen

Welche Art von

Informationen

kann gespeichert

werden?

Wie können

Einträge

beschrieben

werden?

Was ist

sinnvoll zu

speichern?

Domänen-

wissentechnische

Entwicklung

Source: http://spielwarenheinz.com/product_info.php/info/p332_4956-Lego-Haus.html/XTCsid/3e5d2e7afa2213c341d7ddd6e8aff047Was ist

tatsächlich

gespeichert?

22

Archetypen

• wiederverwendbare Informationsmodelle klinischer Konzepte

23

• Beispiel-Eintrag in einer Terminologie:

“Der systolische Blutdruck ist der Druck des Blutes in einer

Arterie während der systolischen Herzphase”

Archetypen vs. Terminologien

openEHR

Position

State

Systolic

Diastolic

Data

0..11

Blood pressure

Protocol

0..1

mm[Hg]

mm[Hg]

0-1000

0-1000Terminologie

24

Nach:

Th

om

as B

eale

, S

am

Heard

(2004):

Arc

hety

pes a

nd T

em

pla

tes H

L7 A

tla

nta

2004 T

uto

ria

l.

Archetypen vs. Ontologien

Position

Systolic

Diastolic

Blood pressure

mm[Hg]

mm[Hg]

Pressure

Intra-vascular

Pressure

Arterial

Pressure

Systemic

Applies to

Whole body

Systolic Arterial

Pressure

Has phase

Heart cycle

phase

Has phase

Systolic

phase

Diastolic Arterial

Pressure

Part of

Has phase

Diastolic

phase

Blood

Pressure

Has units

ISO pressure

units

Has units

mm[Hg]

Has positionBody

position

openEHR

25

Realisierung

Archetyp „Clinical Trial“

26

27

Clinical Knowledge Manager

Archetypen

Repository

Informationen

• Voraussetzung: Nutzung gleicher Archetypen /

gemeinsames Repository.

openEHR

CDA

1980 20001990 2010 2020

V2

1987

Fresh

Look

2011

V3

CDA

2005

FHIR

STU 3

2016

Start V3

1995

V2

V3

FHIR

Quelle: HL7

HL7 Standardentwicklung

HL7 CDA

• Clinical Documment Architecture (CDA)

• Ab Version 2.* XML basiert

• Formatsbezogener Standard auf XML Basis

• Strukturierte Beschreibung für alle klinischen Dokumente

– Stammdatenblätter, Entlassungsbriefe, Bildbefunde, Laborbefunde, …

• Einsatz für elektronische Krankenakte und elektronischen

Datenaustausch den Leistungserbringern

• Inhalte sind menschenlesbar (naja…)

2929

HL7 CDA

• CDA v2.* Eigenschaften:

– Dokumentenstruktur oftmals mächtiger als es der Anwendungsfall

verlangt

– Wenige Pflichtfelder

– Unterstützung von jeder Art von Codiersystem

• LOINC, SNOMED, ICD, OPS, ...

– Erweiterbar

– Einbindung oder Verweis auf externe Dokumente

• CDA v2.* basiert auf einem Referenzinformationsmodell (HL7 v3

RIM)

3030

HL7 CDA

• 3 Stufen der Strukturiertheit

– CDA-Level 1: grobe Struktur mit Freitexten

– CDA-Level 2: Struktur mit klar definiertem Aufbau

– CDA-Level 3: streng strukturiertes und codiertes Dokument,

punktgenaues navigieren im Dokument möglich

• CDA auch als Containerformat für Dokumentenmanagement

geeignet

– Header: Dokumentenart, Autor, Patient, Änderungs- und

Zugriffsverlauf, Kontext zum Dokument, ...

– Body: PDF-Datei, Word-Datei, DICOM-Bilder, Audiodaten, Videos,

…

3131

HL7 CDA

3232

HL7 FHIR (Fast Health InteroperabilityResources)HL7-Nachrichten sind der Kommunikationsstandard von Software- Komponenten in einem Krankenhausinformationssystem

o V2: einfaches Textformat mit Trennzeichen

o V3: XML (war ein Fehlschlag, zu komplex)

o Heute: sichere Kommunikation über offene Netze nötig

o FHIR: nutzt vorhandene Web-Standards (viele APIs verfügbar)

o FHIR beschreibt Datenformate, Datenzugriff und Ressourcen

Server/ServiceClient

FHIR Resources/Resource Types

HTTP methods: get, put, post, delete

GET

PUT

POST

DELETE

HTTP/URIs

XML/JSON/RDF

SSL/OAuth

HL7 FHIR Ressourcen

FHIR Storyboard

8-jähriger Junge

Erstaufnahme

Er klagt über Schmerzen im Ohr seit 4 Tagen mit

aerhöhter Temperatur. Die Temperature liegt bei 38,5°C .

Er hat eine entzündlich veränderte Schleimheaut im Ohr

ohne Perforation. Diagnose: Mittelohrentzündung.

Amoxicillin 250mg 3/ Tag für 7 Tage wird verschrieben.

Nachbehandlung

2 Tage später kommt er mit Juckreiz. Keine Probleme beim

Atmen. Während der anamnese fallen Hautveränderungn

an beidne Armen auf. Diagnose: Penicillinallergie.

Antibiotika werden verändert zu to Erythromycin 250mg 4/

Tag für 10 Tage.

Patient

Encounter

Condition

Observation

Medication

Allergy Intolerance

Quelle: HL7

Encounter

Encounter

Practitioner

Patient

Asserter

Performer

Performer

Performer

Performer

Performer

Performer

Asserter

Asserter

Prescriber

Asserter

Pain right ear 3 days

Otitis media

Itchy skin rash

No breathing difficulties

Elevated temperature

Temperature 38°C

Inflamed right drum

Urticarial Rash

Amoxicillin 250mg

Erythromycin 250mg

Penicillin Allergy

Verknüpfte Ressourcen

Quelle: HL7

Struktur der Ressource Observation

37

Beispiel

Observation

Patientengewicht

38

Klinische Terminologien

39

40

Ziel

• Befüllung des Metadata Repositories soll nicht bei 0 beginnen

• Jahrzehntelange Erfahrung und Vorarbeiten nutzen

• Sicherstellung der semantischen Interoperabilität durch

Referenzierung konsentierter Konzepte

– Bsp.: Variable start date: Was bedeutet das?

• CDASH start date:

– Natürlichsprachige Definition: „Date when the medication was first

taken.“

– Definiertes Format: ISO 8601

– Bezug zu SDTM-Variable: CMSDTDC

Begriffe in der medizinischen Dokumentation

• Konzept/ Begriff: abstract unit of thought, an einen Träger

gebunden

• Hierarchie: Unterordnung unter einen Oberbegriff

– Mono-/ Multihierarchisch

• Kategorie: semantische Achsen (Bezugssystem)

– Mono-/ Multiaxial

• Relation: „Verbindung“ zwischen Konzepten, erlaubt den Aufbau

semantischer Netze

41

Typen von begrifflichen Ordnungssystemen

Nach Komplexität ihrer Struktur aufsteigend:

1. Vokabular

2. Nomenklatur

3. Thesaurus

4. Klassifikation

5. Taxonomie

6. Ontologie

42

Vokabular

• Einfachste Form eines Ordnungssystems

• Menge von Konzepten, jedes Konzept wird durch einen

Bezeichner repräsentiert

• Sonderfall: (ein durch eine Partei) kontrolliertes Vokabular

• Vokabulare gewinnen stark an Bedeutung, da sie relativ schnell

und von mehreren Personen parallel erstellt werden können

(teilweise sogar automatisiert)

– Schlagwortlisten

– Tagging

• Beispiel: Dublin Core (Bibliografische Metadaten)

43

Nomenklatur

• Ähnlich zum Vokabular: Menge von Konzepten, jedes Konzept

wird durch einen Bezeichner repräsentiert

• Aber die Konzepte einer Domäne sollen vollständig erfasst

werden

• Entspricht häufig einer „Namenskonvention“

• Beispiel: LOINC (Laborwerte)

44

Thesaurus

• Konzepte sind systematisch geordnet (und sei es nur alphabetisch)

• Synonyme Bezeichner werden erfasst

• Zwischen Begriffen können Relationen existieren:

– Assoziative

– Hierarchische

• Genauer Typ der Relation nicht spezifiziert

• Beispiele:

– Medical Subject Headings (MeSH)

– Vokabulare in SKOS

45

Klassifikation

• Systematische Ordnung in abstrakte Kategorien

• Meistens hierarchisch

• Klassenbildendes Merkmal (disjunkt, vollständig)

• Möglichst geringe Varianz in der Verteilung

• Klassifikationen sind schwerer zu erstellen, dafür relativ stabil

• Beispiel: ICD-10, ICD-O, TNM

46

Taxonomie

• Sonderform der Klassifikation

• Monohierarchisch

• Ordnungsrelation ist die harte Subsumptionsbeziehung (is_a im

Sinne von subClass)

• Beispiel: Linnés biologische Taxonomie „Systema Naturae“,

MedDRA

47

Ontologie

• Ursprünglich philosophischer Begriff „Wissenschaft des Seins“

• Heute für eine Wissensbasis einer Domäne verwendet => auch

ein Modewort

• Formales System logischer Konstrukte

– Wird durch eine formale Sprache beschrieben

– Hat eine formale Semantik

• Basiert auf einer Logik verschiedener Ausdrucksmächtigkeit

(Beschreibungslogik, Prädikatenlogik erster Stufe, Common Logic)

• Beispiel: siehe NCBI Bioportal, OBO Foundry

48

Medizinische Terminologien: Vorteile strukturierter Erfassung

49

S. Thun (TMF-School 2015)

Wichtige medizinische Terminologien

• ICD-10 GM und Alpha-ID – Diagnosen

• OPS – Prozeduren (chirurgische Eingriffe)

• ATC – Arzneimittelwirkstoffe

• TNM – Krebserkrankungen

• MedDRA – Unerwünschte Ereignisse

• LOINC – Laborwerte

• UCUM – Maßeinheiten

• SDTM – Ergebnisdatensätze klinischer Studien

• CDASH – Standarddatenelemente für klinische Studien

• SNOMED CT – (alle Domänen)

50

51

ICD-10 (International Statistical Classification)

• Weltweit wichtigste Diagnoseklassifikation

– Wird von der Weltgesundheitsorganisation gepflegt

– Regelmäßig starke Überarbeitungen

• Ursprung: Erfassung von Todesursachen

– Im 19. Jhd. Viele Infektions- und Lebensstilkrankheiten

– ICD-1 von 1900

• Jedes Land kann Detailschlüssel selbst festlegen

– ICD-10 GM: German Modification

– Wird im Krankenhaus für alle Diagnosen und Abrechnungen genutzt

52

ICD-10 (International Statistical Classification)

• Aufbau:

– Einachsige hierarchische Klassifikation der Krankheiten

• Umfang:

– 22 Hauptkapitel

• Beispiel:

– C81 Hodgkin-Lymphom (3-Steller, weltweit gleich)

– C81.0 Noduläres lymphozytenprädominantes Hodgkin-Lymphom

(Verfeinerung für Deutschland)

• Wird auch von Wikipedia verwendet

53

Alpha-ID

54

• Textuelle Label für ICD-10: Ergänzung um umgangssprachliche

Bezeichnungen

G Alpha-ID ICD-Schlüssel Text

1 I85501 C81.0Hodgkin-Krankheit mit lymphozytär-histiozytärer

Prädominanz

1 I31550 C81.0 Hodgkin-Paragranulom

1 I116031 C81.0Noduläres lymphozytenprädominantes Hodgkin-

Lymphom

1 I116032 C81.0 Noduläres Paragranulom

OPS (Operationen- und Prozedurenschlüssel)

• Deutsche Entwicklung

– Lehnt sich aber an ICPM an

• Verwendung:

– Verschlüsselung operativer Maßnahmen und anderer medizinischer

Prozeduren

– Im Krankenhaus verpflichtend, aber auch bei ambulanter

Behandlung verwendet

• Wird (genauso wie ICD-10 GM) vom DIMDI (Deutsches Institut für

• Medizinische Dokumentation und Information) in Köln gepflegt

– Jährliche Updates

55

OPS (Operationen- und Prozedurenschlüssel)

• Aufbau:

– monohierarchische Klassifikation, die medizinische Maßnahmen

primär nach Art und nach Lokalisation einteilt

• Beispiel:

56

Diagnosebezogene Fallgruppen (DRG)

• Aufbau:

– 4-stelliger

• 1. Stelle: Hauptdiagnose aus ICD-10

• 2.+3. Stelle: Maßnahmen/Prozeduren aus OPS

• 4. Stelle: Schweregrad

• Verwendung:

– Abrechnungsdaten der Krankenhäuser gegenüber den

Krankenkassen

– kein medizinisch-orientiertes System: Abbildung von

Behandlungsverläufen mit ähnlichem ökonomischen Aufwand in eine

Entgeltgruppe

– Jahrgangsversionen

Standards II – Matthias Löbe – 04.06.2013 57

DRG-Beispiel Fallpauschalen-Katalog 2011

Herzinsuffizienz und Schock

F 62 A2. + 3. Stelle:

Chirurgisch: 0-39Sonstige: 40-59Medizinisch: 60-99

Prozeduren(OPS)

1.Stelle: Hauptdiagnose-Gruppe (MDC)

Hauptdiagnose

(ICD-10-GM)

4. Stelle: Schweregrad

A, B, .. H, I und ZNebendiagnosen

(ICD-10-GM)

559 Basis-DRGs

1.194 abrechenbare DRGs

59

Auswirkung der DRG-Codierung

Fallpauschalen-Katalog 2011Kalkulation mit dem Landesbasisfallwert 2011 für Sachsen: 2.884 €

2.359 €

3.680 €

4.392 €

Anatomisch-Therapeutisch-Chemisches Klassifikationssystem (ATC)

• Aufbau:

– 5 Ebenen

• Verwendung:

– internationale Klassifikation für Arzneistoffe

– Klassifiziert Wirkstoffe, nicht Medikamente („Aspirin“ ist nicht

enthalten)

• Bsp.: Acetylsalicylsäure hat den ATC-Code N02BA01

– 1. Buchstabe N – Nervensystem

– 2. Zahl 02 – Analgetika

– 3. Buchstabe B – „Andere Analgetika und Antipyretika“.

– 4. Buchstabe A – Salicylsäure und Derivate

– 5. Zahl 01 – Acetylsalicylsäure

Standards II – Matthias Löbe – 04.06.2013 60

TNM (Klassifikationssystem für maligneTumore)

• Aufbau:

– Tumorklassifikation: einheitliche Stadieneinteilung maligner

(=bösartiger) Tumorfe

• Primärachsen

– Größe des Tumors (T)

– Beteiligung der Lymphknoten (N)

– Vorhandensein von Metastasen (M)

• Wichtige Parameter: C-Faktor (Zuverlässigkeit), Klinische und

pathologische Klassifikation, Grad

61

TNM (Klassifikationssystem für maligneTumore)

• Verwendung:

– Krebsregister

– Krankheitsgeschichte, unerwünschte Ereignisse

– Nebenwirkungen und Begleiterscheinungen

• Komplexes Beispiel:

– G3pT3pN1 (2/27)pMX R0L1V1 Pn0

62

LOINC (Logical Observation IdentifiersNames and Codes)

• Amerikanisches System zur Beschreibung von Labor- und

Testwerten (Regenstrieff-Institut)

– Blutdruck, Herz-und Atmungsfrequenz

– Notfalluntersuchungen, Herzleistung, Körpermaße,

Körpertemperatur, Stoffwechsel

– Mikrobiologie, Toxikologie, EKG, Sonographie (Geburtshilfe,

Urologie), gastrointestinale Endoskopie

– Beatmungsverfahren, Zähne, Notaufnahme, radiologische

Untersuchungen

– Dokumentenarten

• Deutsche Übersetzung vom DIMDI

– Trotzdem (leider) in Deutschland nur punktuell verbreitet

63

LOINC (Logical Observation IdentifiersNames and Codes)

• Aufbau:

– Sechsachsiges System, präkoordiniert

• Umfang:

– 75.000 Einträge, neue Vorschläge aus der Community möglich

Top 80 Codes => 80% aller Kodierungen in Anwendung

Top 784 Codes => 99% aller Kodierungen in Anwendung

• Beispiel:

– Kreatinin im Urin

64

CodeKomponente

(Analyt)

Gemessene

Eigenschaft

(Messgröße)

Zeit-

angaben

Art der Probe

(System)

Art der

SkalierungMethode

2161-8 CREATININE MCNC PT UR QN

– International etablierte Terminologien

• LOINC zur Charakterisierung der Laborparameter

• UCUM für Maßeinheiten

– Bisher fehlende Durchdringung im deutschen Laborbereich

• Identifizierung eines priorisierten Subsets von 300 – 2.000 LOINC-

Codes

• Mapping lokaler Analyte manuell oder über Gerätelisten

Seite 65

Exkurs: MII Basismodul Laborbefunde:Taskforce "LOINC 1000+"

Konkretisierung Laborbefunde:Beispiel Befundvolumen UK Erlangen

Seite 66

80% Abdeckung mit ~300 Parametern

98% Abdeckung mit ~2.000 Parametern

Per

zen

til B

efu

ndvolu

men

Anzahl Analyte

UCUM (Unified Code for Units of Measure)

• Aufbau:

– Beschreibung vom Maßeinheiten (Maßeinheiten fehlen bei LOINC)

zusammengesetzt aus einer relativ kleinen Zahl von "atomaren"

Symbolen und Operatoren: Basiseinheiten, Präfixe, abgeleitete

Einheiten mit Umrechnungen

• Umfang:

– Unendlich, da keine Tabelle, sondern eine Bildungsvorschrift

• Verwendung:

– Vorzugseinheiten, Umrechnung, Gültigkeitsprüfungen

– Idee: eindeutige Schreibweise auf Compuerbildschirmen!

67

Name Kind of quantity Print Symbol case sensitive Symbol case insensitive

meter length m m M

MedDRA (Medical Dictionary for Regulatory Activities)

• Aufbau:

– Fünfstufiges hierarchisches Wörterbuch von Begriffen rund um

Arzneimittel

• Umfang:

– 66.000 Terme in 26 Organklassen

• Verwendung:

– Studienmedikamentation

– Begleitmedikamentation

• Beispiel:

– 10005461 Kreatin im Blut (8 Stellen)

68

Quelle: ICH

CDISC SDTM

• Study Data Tabulation Model (SDTM)

– Entwickelt von der SDS, SEND und PRG

• Inhaltsbezogener Standard für Bezeichungen von

Studienbegriffen und Studiendaten (Spezifikation)

– Studiendesign, Datentabellen

• Seit April/2006 offizielles Einreichungsformat für

Medikamentenzulassungsstudien bei der FDA

– Vorgabe, mit welchen Spaltennamen Daten an die FDA übermittelt

werden müssen

• Beschreibung in tabellarischer Form (CSV, Excel, XML)

– CSV wegen techn. Nähe zu SAS für die FDA

6969

SDTM (Study Data Tabulation Model)

• Zweck:

– Beschreibung von Studienergebnissen (Annotation von Items)

– Hierarchisches Klassifikationssystem mit Domänen

– Anlehnung an BRIDG

• Umfang:

– >10.000, Elemente

– 30 Domaingruppen (AE – Adverse Events, MH – Medical History, ...)

7070

Domain

PrefixVariable Name Variable Label Type

Codelist

or FormatRole

CDISC Notes (for domains)

Description (for General Classes)Core

DM RFICDTC

Date/Time of

Informed Consent Char ISO 8601

Record

Qualifier

Date/time of informed consent in ISO 8601

character format … Exp

DM RFPENDTC

Date/Time of End of

Participation Char ISO 8601

Record

Qualifier

Date/time when subject ended participation or

follow-up in a trial … Exp

DM DTHDTC Date/Time of Death Char ISO 8601

Record

Qualifier

Date/time of death for any subject who died, in

ISO 8601 format … Exp

DM DTHFL Subject Death Flag Char (NY)

Record

Qualifier

Indicates the subject died. Should be Y or null.

Should be populated even when the death … Exp

CDASH (Clinical Data Acquisition Standards Harmonization)

• Aufbau:

– Bibliothek „echter“ Datenelemente für klinische Studien

– Basisdatensatz für breitestmögliche Anwendung (80/20)

– Kulturspezifisch (Rasse, Ethnie), unterspezifiziert (Codelisten)

– Verweis auf SDTM, wo möglich

– Ebenfalls tabellarische Form

• Umfang:

– Ca. 250 Items in 16 Domänen

71

Domain Order Question TextVariable

NameCodelist Core

Data

Type

CM 1 Were any medications taken? CMYN NY Optional

CM 2 What is the medication /treatment identifier? CMSPID Optional Char

CM 3What was the term for the medication/therapy taken?

or What was the term for the medication taken?CMTRT

Highly

Recomme

nded

Char

SNOMED CT (Systematisierte Nomenklatur der Medizin - Clinical Terms)

• Vollständigste und aktuellste Sammlung des medizinischen

Wissens

– Umfasst andere Terminologien wie ICD oder LOINC (Crossmap)

– Kostenpflichtige Lizenz nötig => D hat keine, Rechtsstreits

• Verwendung:

– Praktisch der gesamte Bereich der Medizin, z.B. für gerade auch

Elektronische Krankenakten

• Umfang:

– Über 300.000 feingranulare Konzepte mit 800.000 Bezeichnern

– 900.000 Relationen

72

SNOMED CT (Systematisierte Nomenklatur der Medizin - Clinical Terms)

• Aufbau:

– Achtzehnachsiges System, postkoordiniert

– Ist als einzige Terminologie logikbasiert (Beschreibungslogik)

– Referenziert vom HL7 RIM

• Beispiel:

– Name: “Herzinfarkt”

(Myocardial infarction)

Concept ID: 22298006

73

Quelle: IHTSDO

74

Probleme (1): Codemapping

ChocolateCT Term ICC-GM

Twix

Snickers

Kit Kat

Bounty

Smarties

Milky Way

Mars

Quelle: Alan Rector

75

Probleme (2): Codevielfalt

• Codes für Unfälle mit

Fahrradfahrern

ICD-9 (E826) 8

READ-2 (T30..) 81

READ-3 87

1999 ICD-10 …

Quelle: Alan Rector

t opCl ass

I Cer t ai n i nf ect i ous and par as i t i c di seases

I I Neopl asm s

I I I Di seases of t he bl ood and bl ood- f or m i ng or gans and cer t ai n di sor der s i nvol vi ng t he i m m une m echani sm

I V Endocr i ne, nut r i t i onal and m et abol i c di seases

V Ment al and behavi our al di sor der s

VI Di seases of t he ner vous sys t em

VI I Di seases of t he eye and adnexa

VI I I Di seases of t he ear and m as t oi d pr ocess

I X Di seases of t he ci r cul at or y sys t em s

X Di seases of t he r espi r at or y sys t em

XI Di seases of t he di ges t i ve sys t em

XI I Di seases of t he ski n and subcut aneous t i s sue

XI I I Di seases of t he m uscul oskel et al sys t em and connect i ve t i s sue

XI V Di seases of t he geni t our i nar y sys t em

XV Pr egnancy, chi l dbi r t h and t he puer per i um

XVI Cer t ai n condi t i ons or i gi nat i ng i n t he per i nat al per i od

XVI I Congeni t al m al f or m at i ons , def or m at i ons and chr om osom al abnor m al i t i es

XVI I I Sym pt om s, s i gns and abnor m al cl i ni cal and l abor at or y f i ndi ngs , not el sewher e cl assi f i ed

XI X I nj ur y, poi soni ng and cer t ai n ot her consequences of ext er nal causes

XX Ext er nal causes of m or bi di t y and m or t al i t y

V01- V99 Tr anspor t acci dent s

V01- V09 Pedes t r i an i nj ur ed i n t r anspor t acci dent

V10- V19 Pedal cycl i s t i nj ur ed i n t r anspor t acci dent

V10 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al

V10. 0 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , nont r af f i c acci dent

V10. 00 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V10. 01 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V10. 02 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V10. 03 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V10. 04 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V10. 08 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V10. 09 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V10. 1 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , nont r af f i c acci dent

V10. 10 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V10. 11 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V10. 12 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V10. 13 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V10. 14 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V10. 18 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V10. 19 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V10. 2 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent

V10. 20 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V10. 21 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V10. 22 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V10. 23 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V10. 24 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V10. 28 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V10. 29 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V10. 3 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , whi l e boar di ng or al i ght i ng

V10. 30 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , whi l e boar di ng or al i ght i ng, whi l e engaged i n spor t s act i vi t y

V10. 31 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , whi l e boar di ng or al i ght i ng, whi l e engaged i n l ei sur e act i vi t y

V10. 32 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , whi l e boar di ng or al i ght i ng, whi l e wor ki ng f or an i ncom e

V10. 33 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her t ypes of wor k

V10. 34 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , whi l e boar di ng or al i ght i ng, whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V10. 38 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her speci f i ed act i vi t i es

V10. 39 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , whi l e boar di ng or al i ght i ng, dur i ng unspeci f i ed act i vi t y

V10. 4 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , t r af f i c acci dent

V10. 40 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V10. 41 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V10. 42 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V10. 43 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V10. 44 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V10. 48 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V10. 49 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , dr i ver , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V10. 5 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , t r af f i c acci dent

V10. 50 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V10. 51 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V10. 52 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V10. 53 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V10. 54 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V10. 58 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V10. 59 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , passenger , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V10. 9 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , t r af f i c acci dent

V10. 90 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V10. 91 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V10. 92 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V10. 93 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V10. 94 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V10. 98 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V10. 99 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h pedes t r i an or ani m al , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V11 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e

V11. 0 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , nont r af f i c acci dent

V11. 00 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V11. 01 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V11. 02 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V11. 03 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V11. 04 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V11. 08 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V11. 09 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V11. 1 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , nont r af f i c acci dent

V11. 10 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V11. 11 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V11. 12 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V11. 13 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V11. 14 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V11. 18 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V11. 19 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V11. 2 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent

V11. 20 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V11. 21 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V11. 22 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V11. 23 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V11. 24 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V11. 28 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V11. 29 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V11. 3 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, whi l e boar di ng or al i ght i ng

V11. 30 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, whi l e boar di ng or al i ght i ng, whi l e engaged i n spor t s act i vi t y

V11. 31 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, whi l e boar di ng or al i ght i ng, whi l e engaged i n l ei sur e act i vi t y

V11. 32 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, whi l e boar di ng or al i ght i ng, whi l e wor ki ng f or an i ncom e

V11. 33 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her t ypes of wor k

V11. 34 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, whi l e boar di ng or al i ght i ng, whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V11. 38 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her speci f i ed act i vi t i es

V11. 39 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, whi l e boar di ng or al i ght i ng, dur i ng unspeci f i ed act i vi t y

V11. 4 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , t r af f i c acci dent

V11. 40 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V11. 41 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V11. 42 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V11. 43 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V11. 44 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V11. 48 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V11. 49 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, dr i ver , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V11. 5 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , t r af f i c acci dent

V11. 50 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V11. 51 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V11. 52 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V11. 53 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V11. 54 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V11. 58 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V11. 59 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, passenger , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V11. 9 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent

V11. 90 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V11. 91 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V11. 92 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V11. 93 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V11. 94 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V11. 98 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V11. 99 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her pedal cycl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V12 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e

V12. 0 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , nont r af f i c acci dent

V12. 00 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V12. 01 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V12. 02 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V12. 03 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V12. 04 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V12. 08 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V12. 09 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V12. 1 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , nont r af f i c acci dent

V12. 10 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V12. 11 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V12. 12 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V12. 13 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V12. 14 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V12. 18 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V12. 19 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V12. 2 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent

V12. 20 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V12. 21 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V12. 22 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V12. 23 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V12. 24 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V12. 28 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V12. 29 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V12. 3 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, whi l e boar di ng or al i ght i ng

V12. 30 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, whi l e boar di ng or al i ght i ng, whi l e engaged i n spor t s act i vi t y

V12. 31 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, whi l e boar di ng or al i ght i ng, whi l e engaged i n l ei sur e act i vi t y

V12. 32 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, whi l e boar di ng or al i ght i ng, whi l e wor ki ng f or an i ncom e

V12. 33 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her t ypes of wor k

V12. 34 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, whi l e boar di ng or al i ght i ng, whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V12. 38 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her speci f i ed act i vi t i es

V12. 39 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, whi l e boar di ng or al i ght i ng, dur i ng unspeci f i ed act i vi t y

V12. 4 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , t r af f i c acci dent

V12. 40 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V12. 41 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V12. 42 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V12. 43 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V12. 44 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V12. 48 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V12. 49 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, dr i ver , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V12. 5 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , t r af f i c acci dent

V12. 50 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V12. 51 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V12. 52 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V12. 53 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V12. 54 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V12. 58 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V12. 59 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, passenger , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V12. 9 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent

V12. 90 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V12. 91 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V12. 92 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V12. 93 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V12. 94 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V12. 98 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V12. 99 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h t wo- or t hr ee- wheel ed m ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V13 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van

V13. 0 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , nont r af f i c acci dent

V13. 00 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V13. 01 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V13. 02 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V13. 03 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V13. 04 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V13. 08 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V13. 09 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V13. 1 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , nont r af f i c acci dent

V13. 10 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V13. 11 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V13. 12 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V13. 13 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V13. 14 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V13. 18 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V13. 19 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V13. 2 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent

V13. 20 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V13. 21 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V13. 22 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V13. 23 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V13. 24 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V13. 28 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V13. 29 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V13. 3 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, whi l e boar di ng or al i ght i ng

V13. 30 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, whi l e boar di ng or al i ght i ng, whi l e engaged i n spor t s act i vi t y

V13. 31 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, whi l e boar di ng or al i ght i ng, whi l e engaged i n l ei sur e act i vi t y

V13. 32 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, whi l e boar di ng or al i ght i ng, whi l e wor ki ng f or an i ncom e

V13. 33 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her t ypes of wor k

V13. 34 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, whi l e boar di ng or al i ght i ng, whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V13. 38 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her speci f i ed act i vi t i es

V13. 39 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, whi l e boar di ng or al i ght i ng, dur i ng unspeci f i ed act i vi t y

V13. 4 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , t r af f i c acci dent

V13. 40 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V13. 41 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V13. 42 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V13. 43 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V13. 44 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V13. 48 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V13. 49 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, dr i ver , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V13. 5 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , t r af f i c acci dent

V13. 50 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V13. 51 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V13. 52 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V13. 53 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V13. 54 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V13. 58 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V13. 59 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, passenger , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V13. 9 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , t r af f i c acci dent

V13. 90 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V13. 91 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V13. 92 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V13. 93 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V13. 94 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V13. 98 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V13. 99 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h car , pi ck- up t r uck or van, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V14 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus

V14. 0 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , nont r af f i c acci dent

V14. 00 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V14. 01 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V14. 02 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V14. 03 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V14. 04 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V14. 08 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V14. 09 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V14. 1 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , nont r af f i c acci dent

V14. 10 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V14. 11 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V14. 12 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V14. 13 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V14. 14 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V14. 18 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , nont r af f i c, whi l e engaged i n ot her speci f i ed act i vi t i es acci dent

V14. 19 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , nont r af f i c, dur i ng unspeci f i ed act i vi t y acci dent

V14. 2 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent

V14. 20 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V14. 21 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V14. 22 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V14. 23 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V14. 24 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V14. 28 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V14. 29 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V14. 3 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , whi l e boar di ng or al i ght i ng

V14. 30 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , whi l e boar di ng or al i ght i ng, whi l e engaged i n spor t s act i vi t y

V14. 31 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , whi l e boar di ng or al i ght i ng, whi l e engaged i n l ei sur e act i vi t y

V14. 32 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , whi l e boar di ng or al i ght i ng, whi l e wor ki ng f or an i ncom e

V14. 33 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her t ypes of wor k

V14. 34 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , whi l e boar di ng or al i ght i ng, whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V14. 38 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her speci f i ed act i vi t i es

V14. 39 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , whi l e boar di ng or al i ght i ng, dur i ng unspeci f i ed act i vi t y

V14. 4 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , t r af f i c acci dent

V14. 40 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , t r aff i c acci dent , whi l e engaged i n spor t s act i vi t y

V14. 41 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , t r aff i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V14. 42 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , t r aff i c acci dent , whi l e wor ki ng f or an i ncom e

V14. 43 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , t r aff i c acci dent , whi l e engaged i n ot her t ypes of wor k

V14. 44 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , t r aff i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V14. 48 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , t r aff i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V14. 49 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , dr i ver , t r aff i c acci dent , dur i ng unspeci f i ed act i vi t y

V14. 5 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , t raf f i c acci dent

V14. 50 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V14. 51 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V14. 52 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V14. 53 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V14. 54 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V14. 58 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V14. 59 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , passenger , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V14. 9 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , t r af f i c acci dent

V14. 90 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V14. 91 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V14. 92 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V14. 93 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V14. 94 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V14. 98 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V14. 99 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h heavy t r anspor t vehi cl e or bus , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V15 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e

V15. 0 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , nont r af f i c acci dent

V15. 00 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V15. 01 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V15. 02 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V15. 03 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V15. 04 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V15. 08 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V15. 09 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V15. 1 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , nont r af f i c acci dent

V15. 10 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V15. 11 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V15. 12 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V15. 13 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V15. 14 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V15. 18 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V15. 19 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V15. 2 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent

V15. 20 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V15. 21 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V15. 22 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V15. 23 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V15. 24 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V15. 28 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V15. 29 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V15. 3 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, whi l e boar di ng or al i ght i ng

V15. 30 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, whi l e boardi ng or al i ght i ng, whi l e engaged i n spor t s act i vi t y

V15. 31 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, whi l e boardi ng or al i ght i ng, whi l e engaged i n l ei sur e act i vi t y

V15. 32 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, whi l e boardi ng or al i ght i ng, whi l e wor ki ng f or an i ncom e, whi l e wor ki ng f or an i ncom e

V15. 33 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, whi l e boardi ng or al i ght i ng, whi l e engaged i n ot her t ypes of wor k

V15. 34 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, whi l e boardi ng or al i ght i ng, whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V15. 38 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, whi l e boardi ng or al i ght i ng, whi l e engaged i n ot her speci f i ed act i vi t i es

V15. 39 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, whi l e boardi ng or al i ght i ng, dur i ng unspeci f i ed act i vi t y

V15. 4 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , t r af f i c acci dent

V15. 40 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , t raf f i c acci dent , whi l e engaged i n spor t s act i vi t y

V15. 41 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , t raf f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V15. 42 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , t raf f i c acci dent , whi l e wor ki ng f or an i ncom e

V15. 43 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , t raf f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V15. 44 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , t raf f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V15. 48 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , t raf f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V15. 49 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, dr i ver , t raf f i c acci dent , dur i ng unspeci f i ed act i vi t y

V15. 5 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , t r af f i c acci dent

V15. 50 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V15. 51 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V15. 52 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V15. 53 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V15. 54 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V15. 58 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V15. 59 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, passenger , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V15. 9 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent

V15. 90 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V15. 91 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V15. 92 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V15. 93 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V15. 94 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V15. 98 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V15. 99 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h r ai l way t r ai n or r ai l way vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V16 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e

V16. 0 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , nont r af f i c acci dent

V16. 00 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V16. 01 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V16. 02 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V16. 03 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V16. 04 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V16. 08 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V16. 09 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V16. 1 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , nont r af f i c acci dent

V16. 10 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V16. 11 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V16. 12 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V16. 13 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V16. 14 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V16. 18 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V16. 19 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V16. 2 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent

V16. 20 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V16. 21 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V16. 22 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V16. 23 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V16. 24 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V16. 28 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V16. 29 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V16. 3 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, whi l e boar di ng or al i ght i ng

V16. 30 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, whi l e boar di ng or al i ght i ng, whi l e engaged i n spor t s act i vi t y

V16. 31 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, whi l e boar di ng or al i ght i ng, whi l e engaged i n l ei sur e act i vi t y

V16. 32 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, whi l e boar di ng or al i ght i ng, whi l e wor ki ng f or an i ncom e

V16. 33 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her t ypes of wor k

V16. 34 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, whi l e boar di ng or al i ght i ng, whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V16. 38 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her speci f i ed act i vi t i es

V16. 39 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, whi l e boar di ng or al i ght i ng, dur i ng unspeci f i ed act i vi t y

V16. 4 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , t r af f i c acci dent

V16. 40 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V16. 41 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V16. 42 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V16. 43 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V16. 44 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V16. 48 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V16. 49 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, dr i ver , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V16. 5 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , t r af f i c acci dent

V16. 50 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V16. 51 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V16. 52 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V16. 53 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V16. 54 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V16. 58 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V16. 59 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, passenger , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V16. 9 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent

V16. 90 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V16. 91 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V16. 92 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V16. 93 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V16. 94 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V16. 98 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V16. 99 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h ot her nonm ot or vehi cl e, unspeci f i ed pedal cycl i s t , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V17 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect

V17. 0 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , nont r af f i c acci dent

V17. 00 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V17. 01 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V17. 02 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V17. 03 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V17. 04 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V17. 08 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V17. 09 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V17. 1 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , nont r af f i c acci dent

V17. 10 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V17. 11 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V17. 12 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V17. 13 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V17. 14 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V17. 18 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V17. 19 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V17. 2 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent

V17. 20 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V17. 21 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V17. 22 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V17. 23 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V17. 24 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V17. 28 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V17. 29 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V17. 3 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , whi l e boar di ng or al i ght i ng

V17. 30 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , whi l e boar di ng or al i ght i ng, whi l e engaged i n spor t s act i vi t y

V17. 31 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , whi l e boar di ng or al i ght i ng, whi l e engaged i n l ei sur e act i vi t y

V17. 32 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , whi l e boar di ng or al i ght i ng, whi l e wor ki ng f or an i ncom e

V17. 33 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her t ypes of wor k

V17. 34 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , whi l e boar di ng or al i ght i ng, whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V17. 38 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her speci f i ed act i vi t i es

V17. 39 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , whi l e boar di ng or al i ght i ng, dur i ng unspeci f i ed act i vi t y

V17. 4 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , t r af f i c acci dent

V17. 40 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V17. 41 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V17. 42 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V17. 43 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V17. 44 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V17. 48 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V17. 49 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , dr i ver , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V17. 5 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , t r af f i c acci dent

V17. 50 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V17. 51 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V17. 52 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V17. 53 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V17. 54 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V17. 58 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V17. 59 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , passenger , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V17. 9 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , t r af f i c acci dent

V17. 90 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V17. 91 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V17. 92 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V17. 93 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V17. 94 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V17. 98 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V17. 99 Pedal cycl i s t i nj ur ed i n col l i s i on wi t h f i xed or s t at i onar y obj ect , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V18 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent

V18. 0 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , nont r af f i c acci dent

V18. 00 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V18. 01 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V18. 02 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V18. 03 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V18. 04 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V18. 08 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V18. 09 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V18. 1 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , nont r af f i c acci dent

V18. 10 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V18. 11 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V18. 12 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V18. 13 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V18. 14 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V18. 18 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V18. 19 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V18. 2 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent

V18. 20 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V18. 21 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V18. 22 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V18. 23 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V18. 24 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V18. 28 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V18. 29 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , nont r af f i c acci dent , dur i ng unspeci f i ed act i vi t y

V18. 3 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , whi l e boar di ng or al i ght i ng

V18. 30 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , whi l e boar di ng or al i ght i ng, whi l e engaged i n spor t s act i vi t y

V18. 31 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , whi l e boar di ng or al i ght i ng, whi l e engaged i n l ei sur e act i vi t y

V18. 32 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , whi l e boar di ng or al i ght i ng, whi l e wor ki ng f or an i ncom e

V18. 33 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her t ypes of wor k

V18. 34 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , whi l e boar di ng or al i ght i ng, whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V18. 38 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , whi l e boar di ng or al i ght i ng, whi l e engaged i n ot her speci f i ed act i vi t i es

V18. 39 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , whi l e boar di ng or al i ght i ng, dur i ng unspeci f i ed act i vi t y

V18. 4 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , t r af f i c acci dent

V18. 40 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V18. 41 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V18. 42 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e

V18. 43 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V18. 44 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V18. 48 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V18. 49 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , dr i ver , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y, dur i ng unspeci f i ed act i vi t y

V18. 5 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , t r af f i c acci dent

V18. 50 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V18. 51 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V18. 52 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e, whi l e wor ki ng f or an i ncom e

V18. 53 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V18. 54 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V18. 58 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V18. 59 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , passenger , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y, dur i ng unspeci f i ed act i vi t y

V18. 9 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , t r af f i c acci dent

V18. 90 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n spor t s act i vi t y

V18. 91 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n l ei sur e act i vi t y

V18. 92 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e wor ki ng f or an i ncom e, whi l e wor ki ng f or an i ncom e

V18. 93 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her t ypes of wor k

V18. 94 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e r es t i ng, s l eepi ng, eat i ng or engagi ng i n ot her vi t al act i vi t i es

V18. 98 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , whi l e engaged i n ot her speci f i ed act i vi t i es

V18. 99 Pedal cycl i s t i nj ur ed i n noncol l i s i on t r anspor t acci dent , unspeci f i ed pedal cycl i s t , t r af f i c acci dent , dur i ng unspeci f i ed act i vi t y, dur i ng unspeci f i ed act i vi t y

V19 Pedal cyclist injur ed in ot her and unspecif ied t r anspor t accident s

V19. 0 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident

V19. 00 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while engaged in spor t s act ivit y

V19. 01 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while engaged in leisur e act ivit y

V19. 02 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while wor king f or an incom e

V19. 03 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while engaged in ot her t ypes of wor k

V19. 04 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while r est ing, sleeping, eat ing or engaging in ot her vit al act ivit ies

V19. 08 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while engaged in ot her specif ied act ivit ies

V19. 09 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , dur ing unspecif ied act ivit y

V19. 1 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident

V19. 10 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while engaged in spor t s act ivit y

V19. 11 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while engaged in leisur e act ivit y

V19. 12 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while wor king f or an incom e

V19. 13 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while engaged in ot her t ypes of wor k

V19. 14 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while r est ing, sleeping, eat ing or engaging in ot her vit al act ivit ies

V19. 18 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while engaged in ot her specif ied act ivit ies

V19. 19 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , dur ing unspecif ied act ivit y

V19. 2 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident

V19. 20 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while engaged in spor t s act ivit y

V19. 21 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while engaged in leisur e act ivit y

V19. 22 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while wor king f or an incom e

V19. 23 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while engaged in ot her t ypes of wor k

V19. 24 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while r est ing, sleeping, eat ing or engaging in ot her vit al act ivit ies

V19. 28 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , while engaged in ot her specif ied act ivit ies

V19. 29 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in nont r af f ic accident , dur ing unspecif ied act ivit y

V19. 3 Pedal cyclist [ any] injur ed in unspecif ied nont r af f ic accident

V19. 30 Pedal cyclist [ any] injur ed in unspecif ied nont r af f ic accident , while engaged in spor t s act ivit y

V19. 31 Pedal cyclist [ any] injur ed in unspecif ied nont r af f ic accident , while engaged in leisur e act ivit y

V19. 32 Pedal cyclist [ any] injur ed in unspecif ied nont r af f ic accident , while wor king f or an incom e

V19. 33 Pedal cyclist [ any] injur ed in unspecif ied nont r af f ic accident , while engaged in ot her t ypes of wor k

V19. 34 Pedal cyclist [ any] injur ed in unspecif ied nont r af f ic accident , while r est ing, sleeping, eat ing or engaging in ot her vit al act ivit ies

V19. 38 Pedal cyclist [ any] injur ed in unspecif ied nont r af f ic accident , while engaged in ot her specif ied act ivit ies

V19. 39 Pedal cyclist [ any] injur ed in unspecif ied nont r af f ic accident , dur ing unspecif ied act ivit y

V19. 4 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident

V19. 40 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while engaged in spor t s act ivit y

V19. 41 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while engaged in leisur e act ivit y

V19. 42 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while wor king f or an incom e

V19. 43 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while engaged in ot her t ypes of wor k

V19. 44 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while r est ing, sleeping, eat ing or engaging in ot her vit al act ivit ies

V19. 48 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while engaged in ot her specif ied act ivit ies

V19. 49 Dr iver injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , dur ing unspecif ied act ivit y

V19. 5 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident

V19. 50 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while engaged in spor t s act ivit y

V19. 51 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while engaged in leisur e act ivit y

V19. 52 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while wor king f or an incom e

V19. 53 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while engaged in ot her t ypes of wor k

V19. 54 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while r est ing, sleeping, eat ing or engaging in ot her vit al act ivit ies

V19. 58 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while engaged in ot her specif ied act ivit ies

V19. 59 Passenger injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , dur ing unspecif ied act ivit y

V19. 6 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident

V19. 60 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while engaged in spor t s act ivit y

V19. 61 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while engaged in leisur e act ivit y

V19. 62 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while wor king f or an incom e

V19. 63 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while engaged in ot her t ypes of wor k

V19. 64 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while r est ing, sleeping, eat ing or engaging in ot her vit al act ivit ies

V19. 68 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , while engaged in ot her specif ied act ivit ies

V19. 69 Unspecif ied pedal cyclist injur ed in collision wit h ot her and unspecif ied m ot or vehicles in t r af f ic accident , dur ing unspecif ied act ivit y

V19. 8 Pedal cyclist [ any] injur ed in ot her specif ied t r anspor t accident s

V19. 80 Pedal cyclist [ any] injur ed in ot her specif ied t r anspor t accident s, while engaged in spor t s act ivit y

V19. 81 Pedal cyclist [ any] injur ed in ot her specif ied t r anspor t accident s, while engaged in leisur e act ivit y

V19. 82 Pedal cyclist [ any] injur ed in ot her specif ied t r anspor t accident s, while wor king f or an incom e

V19. 83 Pedal cyclist [ any] injur ed in ot her specif ied t r anspor t accident s, while engaged in ot her t ypes of wor k

V19. 84 Pedal cyclist [ any] injur ed in ot her specif ied t r anspor t accident s, while r est ing, sleeping, eat ing or engaging in ot her vit al act ivit ies

V19. 88 Pedal cyclist [ any] injur ed in ot her specif ied t r anspor t accident s, while engaged in ot her specif ied act ivit ies

V19. 89 Pedal cyclist [ any] injur ed in ot her specif ied t r anspor t accident s, dur ing unspecif ied act ivit y

V19. 9 Pedal cyclist [ any] injur ed in unspecif ied t r af f ic accident

V19. 90 Pedal cyclist [ any] injur ed in unspecif ied t r af f ic accident , while engaged in spor t s act ivit y

V19. 91 Pedal cyclist [ any] injur ed in unspecif ied t r af f ic accident , while engaged in leisur e act ivit y

V19. 92 Pedal cyclist [ any] injur ed in unspecif ied t r af f ic accident , while wor king f or an incom e

V19. 93 Pedal cyclist [ any] injur ed in unspecif ied t r af f ic accident , while engaged in ot her t ypes of wor k

V19. 94 Pedal cyclist [ any] injur ed in unspecif ied t r af f ic accident , while r est ing, sleeping, eat ing or engaging in ot her vit al act ivit ies

V19. 98 Pedal cyclist [ any] injur ed in unspecif ied t r af f ic accident , while engaged in ot her specif ied act ivit ies

V19. 99 Pedal cyclist [ any] injur ed in unspecif ied t r af f ic accident , dur ing unspecif ied act ivit y

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1999 ICD10: 587 Codes!

•V31.22 Occupant of three-wheeled motor vehicle injured in collision with pedal cycle, person on outside of vehicle, nontrafficaccident, while working for income

•W65.40 Drowning and submersion while in bath-tub, street and highway, while engaged in sports activity

•X35.44 Victim of volcanic eruption, street and highway, while resting, sleeping, eating or engaging in other vital activities

Que

lle:

Ala

n Re

ctor

77

Explodierender Biker

• 10 mögliche Zielobjekte:– Fußgänger / Fahrrad / Motorrad / Auto / LKW / Zug / motorloses

Gefährt / Baum / Anderes

• 5 Rollen für den Verletzten:– Fahrer / Mitfahrer / Fahrer eines Motorfahrzeugs / Einsteigender /

Anderes

• 5 Aktivitäten des Verletzten:– ruhend / bei der Arbeit / beim Sport / im Urlaub/ Anderes

• 2 Kontexte– Im Verkehr / Ruhender Verkehr

• V12.24: Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities

Zusammenfassung

• In den vergangenen Jahren wurden viele neue Standards im Feld

der klinischen Forschung entwickelt

– Ihre Verbreitung und ihre Unterstützung durch Softwarewerkzeuge ist

überschaubar

• Terminologien existieren seit vielen Jahrzehnten, manche seit über

100 Jahren

– Ihre Benutzung durch Ärzte beschränkt sich auf das absolute

Minimum

– SNOMED enthält 450.000 Codes, 10.000 davon wurden je

produktiv verwendet, aber 500.000 – 750.000 Codes „fehlen“

78