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V43.5XXA is the most common ICD-10-CM external-cause code on a Tennessee auto claim. It documents a car driver hit by another car, pickup, or van during traffic. The headline economic feature of a TN V43.5XXA case is the size of the other driver's policy: Tennessee's $25,000 minimum auto limit (TCA Section 55-12-102) caps a large portion of moderate-severity cases unless you can reach UM and UIM coverage, an umbrella, or a commercial layer (including the $1 million TNC rideshare policies under TCA Section 55-12-141).
V43.5XXA at a glance
V43.5XXA Settlement Value Snapshot (Tennessee, 2026)
Last updated
- Definition
- Car driver injured in collision with car, pick-up truck or van in traffic accident, initial encounter (ICD-10-CM, FY2026). The most common code on TN auto claims.
- TN settlement
- $10,000 to $750,000+. Minor whiplash $10,000 to $50,000; moderate (injections, surgery) $50,000 to $250,000; severe (TBI, surgical disc, permanent impairment) $250,000 to $750,000; catastrophic $750,000 to $5,000,000+ in economic damages.
- TN auto minimum
- $25,000 per person, $50,000 per accident, $15,000 property damage (TCA Section 55-12-102). Approximately 21.3 percent of TN drivers uninsured (5th highest U.S., 2023 IRC).
- TN rideshare
- $1,000,000 primary during Periods 2-3 (TCA Section 55-12-141). Period 1: $50,000 BI per person / $100,000 per accident / $30,000 property damage. Personal insurer may exclude during TNC log-in (TCA Section 56-7-1119).
- TN legal layer
- One-year statute (TCA Section 28-3-104; 2 years if criminal charges). 49% bar comparative (McIntyre v. Balentine). $750,000 non-economic cap (TCA Section 29-39-102).
- A suffix
- Initial encounter. Follow-up becomes V43.5XXD; long-term sequelae become V43.5XXS. TN adjusters flag cases stuck at A more than 30 days post-crash as “treatment-gap.”
Source: SetCalc analysis of Tennessee court records and confirmed settlements, 2025 to 2026. Estimate your V43.5XXA settlement value →
What V43.5XXA Actually Means
V43.5XXA reads character by character as: V43 (car occupant injured in collision with car, pickup, or van), .5 (car driver, traffic accident), XX (two placeholders), A (initial encounter, first visit for active treatment). Closely related codes a Tennessee coder may use on the same chart are V43.6XXA (passenger, the rideshare-passenger code), V43.7XXA (person on the outside of the car), and V43.9XXA (unspecified car occupant). The non-traffic (parking lot, driveway) variants live at V43.0 through V43.3.
V43.5XXA does not say who was at fault
How a V43.5XXA Crash Typically Happens in Tennessee
V43.5XXA covers the full range of car-versus-car traffic collisions. The four patterns we see most often in Tennessee cases:
Rear-end at a signal or in slowed traffic
The single most common V43.5XXA pattern. Distracted-driver rear-end at a red light or in slowed I-40, I-65, or I-24 traffic. Liability is usually clean; the primary defense argument is the paired S-code severity (downgrading whiplash to “pre-existing degeneration”).
Intersection T-bone
Failure to yield at a stop sign or red light. Common at the suburban grids outside Nashville (Brentwood, Franklin, Murfreesboro) and at Memphis arterials. Side-impact injury patterns (S22 ribs, S32 pelvis, S06 TBI from head-strike on door pillar) drive higher severity than rear-ends.
Lane-change blind-spot crash
Heavy on Tennessee's urban interstates (I-40, I-65, I-24, I-440 Davidson County loop). Mutual blind-spot scenarios drive significant comparative-fault disputes; the 49% bar makes each percentage point matter.
Head-on crossover
Cross-centerline crashes on TN secondary roads, often impaired-driver cases. Triggers the 2-year SOL extension under TCA Section 28-3-104(a)(2) when DUI charges are filed. Severity is consistently high (S06 TBI, S22 multi-rib, S32 unstable pelvis).
The Injury Codes Paired With V43.5XXA
V43.5XXA never appears alone on a complete record. The dollar value of the claim flows almost entirely from the paired S-codes. The most common Tennessee pairings:
- Cervical sprain (S13.4): the most common pairing in rear-end V43.5XXA cases. See the whiplash settlement guide.
- Herniated disc (M51.16 cervical / M51.26 lumbar): with or without surgery. See the Tennessee back injury settlement guide.
- Concussion / TBI (S06.0X through S06.9X): the largest value driver in moderate-and-above cases. See the TBI settlement guide.
- Rib and pelvic fractures (S22, S32): side-impact loading from T-bone collisions.
- Lower-extremity fractures (S72 femur, S82 tibia): high-energy T-bone and head-on patterns.
- Shoulder and forearm fractures (S43, S52): bracing injuries during impact.
The Tennessee Policy-Limit Ceiling
The single structural feature that defines most Tennessee V43.5XXA cases is the size of the other driver's policy. TCA Section 55-12-102 sets the auto minimum at:
- $25,000 per person bodily injury
- $50,000 per accident bodily injury
- $15,000 property damage
These minimums were last increased in 2009 (taking effect after a phase-in). A moderate Tennessee V43.5XXA case with a $35,000 medical bill and lost wages can easily exceed the $25,000 per-person limit, leaving the plaintiff under-compensated unless UM and UIM apply.
Tennessee's uninsured-motorist problem is structural. The Insurance Research Council's 2023 estimate put TN at 21.3 percent uninsured, the 5th-highest rate in the country. Identify the available UM/UIM stack before signing anything:
- UM/UIM must be offered at equal limits to BI under TCA Section 56-7-1201(a)(2) unless rejected in writing.
- Anti-stacking: TCA Section 56-7-1201(b)(2) limits you to the UM/UIM on the accident vehicle. You cannot stack across multiple household policies as primary coverage.
- Made-Whole doctrine: under Wimberly v. American Casualty Co. (584 S.W.2d 200, Tenn. 1979), the carrier's subrogation right does not arise until the insured is fully made whole, regardless of policy language. TennCare/Medicaid is an exception (TCA Section 71-5-117).
No direct action against the insurer in Tennessee
Tennessee Settlement Ranges for V43.5XXA Cases
Settlement ranges reflect SetCalc analysis of Tennessee court records and confirmed settlements involving car-versus-passenger-vehicle traffic collisions, 2025 to 2026. The bands track injury severity; the upper end of each band assumes recovery is not constrained by the at-fault driver's policy or the non-economic damages cap.
| Severity Band | Tennessee Range | Typical Paired S-Codes |
|---|---|---|
| Minor (soft tissue, conservative) | $10,000 to $50,000 | S13.4 whiplash, S39.0 lumbar strain, no injections, no surgery |
| Moderate (injections, conservative surgery) | $50,000 to $250,000 | M51.16 / M51.26 disc with injection or microdisc, S06.0X concussion, S22 single rib |
| Severe (TBI, multi-level fusion) | $250,000 to $750,000 | S06.2 moderate TBI, M51 multi-level fusion, S72 femur ORIF, permanent impairment rating |
| Catastrophic | $750,000 to $5,000,000+ | S24 / S34 spinal cord, severe S06 TBI, amputation, life-care-plan economic damages |
| Wrongful death | $750,000 to $10,000,000+ | TCA Section 20-5-106 / 20-5-113; non-econ portion capped, economic uncapped, punitives separately limited |
Source: SetCalc analysis of Tennessee verdicts and confirmed settlements, 2025 to 2026. The non-economic damages cap at TCA Section 29-39-102 ($750,000 standard, $1,000,000 catastrophic) constrains the pain-and-suffering portion; the practical upper bound on most non-rideshare, non-commercial V43.5XXA cases is driven by the $25,000 minimum auto policy on the other side. See the verdict and settlement database for case-by-case comparables.
Tennessee Car-vs-Car Case Examples
Three representative Tennessee case profiles that would carry a V43.5XXA code on the medical chart. Facts are composites drawn from public Tennessee settlements; numbers reflect settlement ranges seen for similar fact patterns.
Example 1: Rear-end at a red light, I-440 (Davidson County, Nashville)
Facts:
34-year-old commuter stopped at a red light on I-440 off-ramp; rear-ended by a distracted driver at approximately 25 mph. Clean liability; driver cited.
Injuries (paired codes):
V43.5XXA + S13.4 cervical sprain + S39.0 lumbar strain. 6 months of physical therapy and chiropractic. No injections, no surgery.
Settlement range: $18,000 to $32,000. Settled at policy mid-point; at-fault driver had a $50,000 policy. Resolution in 8 months.
Example 2: T-bone at intersection, $25K minimum policy + UIM stack (Shelby County, Memphis)
Facts:
47-year-old driver T-boned at a Memphis intersection by a driver who ran a stop sign. At-fault driver carried only the $25,000 TN statutory minimum.
Injuries (paired codes):
V43.5XXA + M51.16 C5-C6 herniation (ACDF surgery) + S06.0X concussion + S22 single rib fracture. 14 months treatment.
Settlement range: $185,000 to $275,000. $25,000 from at-fault driver's primary plus $250,000 UIM stack on plaintiff's household policy. Demonstrates why TN UM/UIM coverage is often the primary recovery layer.
Example 3: Head-on impaired driver, criminal-charges SOL extension (Hamilton County, Chattanooga)
Facts:
52-year-old driver hit head-on by an impaired driver who crossed the centerline. At-fault driver charged with DUI and vehicular assault; SOL extended to 2 years under TCA Section 28-3-104(a)(2).
Injuries (paired codes):
V43.5XXA + S06.2 moderate TBI + S22 multiple rib fractures + S32 unstable pelvis (ORIF) + S72 femur fracture. Permanent impairment rating 25%, unable to return to physical work.
Settlement range: $550,000 to $850,000. At-fault driver had $100,000 / $300,000 policy plus $1M umbrella; non-economic portion neared the $750,000 standard cap; punitive demand under TCA Section 29-39-104 supported by criminal-conduct finding.
Tennessee Legal Context for V43.5XXA Cases
- Statute of limitations: one year from the crash date under TCA Section 28-3-104(a)(1)(A). Extended to two years if criminal charges (Section 28-3-104(a)(2)).
- Comparative fault: 49% bar modified comparative under McIntyre v. Balentine. See the Tennessee comparative negligence page.
- Non-economic damages cap: $750,000 standard, $1,000,000 catastrophic, TCA Section 29-39-102. Economic damages uncapped.
- Punitive cap: TCA Section 29-39-104 limits punitives to the greater of two times compensatory or $500,000 (some exceptions for intentional conduct).
- No direct action against insurer: must obtain judgment against insured first.
- Several liability only: TCA Section 29-11-107.
- Auto-insurance minimums: $25,000 / $50,000 / $15,000 (TCA Section 55-12-102). 21.3% uninsured (2023 IRC).
- UM/UIM: TCA Section 56-7-1201. Must be offered at BI limits unless rejected in writing; anti-stacking under Section 56-7-1201(b)(2).
- Made-Whole doctrine: Wimberly v. American Casualty (Tenn. 1979). Carrier subrogation does not arise until insured is fully made whole.
How a Tennessee Adjuster Reads V43.5XXA
Tennessee carrier severity-evaluation systems (Colossus, Liability Navigator, Claim IQ) ingest diagnosis and external-cause codes from the medical records as scoring inputs. Three things to know about how Tennessee adjusters specifically treat a V43.5XXA chart:
- V43 is the baseline auto crash code in adjuster severity software. V44 (heavy truck) and V03 (pedestrian) score higher at the same paired S-code level; V43 is the reference category. Severity is driven entirely by the paired S-codes.
- Tennessee Farmers Mutual, State Farm, and Allstate are the dominant TN auto insurers. Tennessee Farmers Mutual is a regional-only carrier headquartered in Columbia, TN; its claims operation is well-known for conservative opening offers and lengthy negotiation. State Farm and Allstate apply national-pattern lowball tactics tuned to TN's short 1-year SOL (file pressure favors the carrier) and the 49% bar (every comparative percentage matters).
- Treatment-gap discounting is aggressive in Tennessee. Records stuck at the A (initial encounter) suffix more than 30 days post-crash flag the case for insurer-side discounting. Every TN follow-up visit needs its D suffix to defeat the gap argument.
For more on adjuster severity software, see our Colossus settlement-software guide.
What to Do If V43.5XXA Is on Your Tennessee Hospital Bill
Move fast: TN has a one-year SOL
Identify the at-fault driver's policy limits
Notice your own UM/UIM carrier within 30 days
Confirm rideshare status if any vehicle was on the app
Treat consistently; document every paired S-code
Frequently Asked Questions
What does V43.5XXA mean on my Tennessee hospital bill?
V43.5XXA is the ICD-10-CM external-cause code for a car driver injured in a collision with another car, pickup, or van during traffic, initial encounter. This is the single most common external-cause code on Tennessee auto claims because most TN crashes involve two passenger vehicles. It documents the crash type, not the injury itself and not who was at fault. The final A means initial encounter; follow-up visits become V43.5XXD; long-term sequelae become V43.5XXS.
What is the average car-vs-car settlement in Tennessee?
Tennessee car-versus-car settlements cluster in a $10,000 to $50,000 band for minor cases (whiplash, conservative care), $50,000 to $250,000 for moderate cases involving injections or surgery, and $250,000 to $750,000 for severe cases with TBI, herniated disc with surgery, or significant permanent impairment. Pain-and-suffering recovery is capped at $750,000 standard or $1,000,000 catastrophic under TCA Section 29-39-102; economic damages are uncapped. The single biggest structural cap on Tennessee V43.5XXA recoveries is the $25,000 per-person auto minimum at TCA Section 55-12-102, combined with TN's roughly 21 percent uninsured-driver rate.
How does the Tennessee non-economic damages cap affect a V43.5XXA case?
TCA Section 29-39-102 limits non-economic damages (pain and suffering, loss of enjoyment, loss of consortium) to $750,000 in standard cases and $1,000,000 in catastrophic cases (spinal cord injury, amputation, severe burns, wrongful death of a parent of a minor). The cap applies per injured party. Economic damages (medical bills, lost earnings, future care) are unconstrained. The Tennessee Supreme Court upheld the cap in McClay v. Airport Management. For typical V43.5XXA cases the cap rarely binds in pre-suit posture, but in severe or wrongful-death cases it materially constrains the demand framework.
What if the other driver is uninsured or under-insured in Tennessee?
About 21.3 percent of TN drivers are uninsured (2023 IRC data), the 5th-highest rate in the U.S. If you carry uninsured motorist (UM) coverage on your own policy, you file a UM claim against your own carrier; under TCA Section 56-7-1201(a)(2) Tennessee insurers must offer UM at equal limits to BI unless rejected in writing. UIM stacks on top of an at-fault driver's small policy. Anti-stacking under TCA Section 56-7-1201(b)(2) limits you to the UM/UIM on the accident vehicle. Without UM and UIM, your direct recourse is a personal suit against the at-fault driver's individual assets, which in TN as elsewhere is often a dry well.
Can I sue the other driver's insurance company directly in Tennessee?
No. Tennessee follows the no-direct-action rule: the at-fault driver's liability insurer is not a proper defendant. You sue the driver, obtain a judgment, and then collect from the policy. The Tennessee Farmers Mutual line of cases controls. This procedural framework drives the importance of policy-limit demands and bad-faith setups; if the carrier rejects a reasonable policy-limit demand and the verdict exceeds the limit, the carrier may be exposed for the excess judgment in a follow-on bad-faith action.
Tennessee has a 1-year SOL. How does that work for a car accident?
TCA Section 28-3-104(a)(1)(A) requires you to file within one year of the crash. Extended to two years under Section 28-3-104(a)(2) if criminal charges are brought against the at-fault driver. This is tied with Kentucky and Louisiana for the shortest personal-injury SOL in the country. Critical practical effect on V43.5XXA cases: 12 months is often less than the time it takes to reach maximum medical improvement on a herniated disc or post-concussive case, which creates pressure to file before treatment is complete.
I was an Uber or Lyft passenger when the crash happened. What V-code applies?
If you were a passenger in the rideshare vehicle, you code as V43.6XXA (car passenger hit by another car), not V43.5XXA (driver). The rideshare driver themselves codes V43.5XXA. Both cases are governed by Tennessee's TNC Services Act at TCA Section 55-12-141 and the Public Chapter 520 framework (2015). During Period 3 (passenger on board), Uber and Lyft maintain $1,000,000 in primary commercial liability per occurrence. During Period 2 (driver en route to pickup), the same $1 million applies. During Period 1 (driver logged in, no ride accepted), the statute requires lower contingent coverage. See our Tennessee Uber accident settlement guide at /guides/tennessee-uber-accident-settlement-calculator for the full coverage stack.
How does Tennessee's 49% comparative fault bar apply?
Under McIntyre v. Balentine (1992), a Tennessee plaintiff recovers only if their fault is less than the defendant's. This matters more in V43.5XXA cases than truck cases because car-versus-car liability is often genuinely shared (lane changes, partial-fault rear-ends, intersection disputes). Defense counsel will fight hard over 10-percent and 20-percent fault allocations because the 49% bar is a cliff: 49% fault and you recover (reduced); 50% and you are barred entirely. TCA Section 29-11-107 confirms each defendant pays only its assigned percentage of fault.
What injuries are typically coded along with V43.5XXA?
The dollar value of the claim flows almost entirely from the paired S-codes describing the actual injuries. Most common pairings: S13.4 cervical sprain (whiplash), M51.16 or M51.26 herniated cervical or lumbar disc (with or without surgery), S06.0X through S06.9X traumatic brain injury (concussion through severe TBI), S22 / S32 rib and pelvic fractures, S72 femur fractures, S82 tibia fractures, and S43 / S52 shoulder and forearm fractures from bracing. The S-code severity drives most of the value, not the V-code.
Should I get a Tennessee attorney for a V43.5XXA case?
For minor soft-tissue cases with clean liability and treatment under $5,000, attorney representation may not pay back its 33-percent contingency. For any case involving injections, surgery, lost wages exceeding two weeks, or disputed liability, the data is consistent across states: represented claimants typically recover 2x to 3x what unrepresented claimants do after fees. With Tennessee's 1-year SOL and 49% bar (both shorter / harsher than national norms), the value of early counsel is amplified. See our guide on whether to hire a lawyer at /guides/should-i-get-a-lawyer-for-a-car-accident.
Estimate your V43.5XXA settlement value
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