The Wall Street Journal put out an interesting article about the switch from ICD-9 coding to ICD-10. The title mocks the ICD-10 codes, Walked Into a Lamppost? Hurt While Crocheting? Help Is on the Way”, and the subtitle is funny as well, “New Medical-Billing System Provides Precision; Nine Codes for Macaw Mishaps”
I must admit that I’m not very well steeped in the history of ICD-9 and ICD-10. Nor am I that familiar with the process that was used for creating the voluminous ICD-10 coding system. I’m more of a practical person and so I’ve been more interested in EHR’s ICD-10 preparedness and the timeline for ICD-10 implementation. Seems like we won’t have much choice.
I guess I should have known that going from 18,000 codes (which doctors can’t even stay up with as is) to 140,000 codes would offer some crazy and hilarious codes. Here’s some examples from the article linked above:
There are codes for injuries in opera houses, art galleries, squash courts and nine locations in and around a mobile home, from the bathroom to the bedroom.
And the appropriate follow up question from a family physician, “Really? Bathroom versus bedroom? What difference does it make?”
Some other interesting codes mentioned in the article:
R46.1 is “bizarre personal appearance”
R46.0 is “very low level of personal hygiene”
W22.02XA, “walked into lamppost, initial encounter
W22.02XD, “walked into lamppost, subsequent encounter”
V91.07XA, “burn due to water-skis on fire”
There are codes for injuries received while sewing, ironing, playing a brass instrument, crocheting, doing handcrafts, or knitting—but not while shopping. There are codes for injuries from birds such as: a duck, macaw, parrot, goose, turkey or chicken. I’d hate for my doctor to choose the “bitten by turtle” versus “struck by turtle” code. My insurance company might not reimburse the second.
Do people know of any other off the wall ICD-10 codes?
While this has me a little concerned to see ICD-10 in action, hopefully it will give all of you a good laugh going into the weekend. I can’t say I saw a code for any sort of Friday inefficiency, but there probably should be.
Obviously, with 140,000 they overlooked a few, which I am more than glad to offer:
• C193.44. Yelled fire when he fell into the chocolate.
• F4555.98. Hit by person falling from building more than ten stories tall wearing a blue dress.
• M1664.101. Married to Lorena Bobbit.
• R97.01 Delusional, Severe. Thinks insurance company will cover her procedure.
• Q9983.44 Wants to date Nurse Ratched
• B1111B. Speaks only in palindromes. Takes two hours to get social security number.
• WXXY. Listens to cross dressing radio station.
• Z1.0 Oy, what a nudge!
While the Wall Street Journal may think it’s a laugh, with over 300 million citizens, macaw mishaps are going to happen. The specificity of the codes helps to track public health hazards that could occur in pockets due to particular services, vendors, products, or even the pet de la mode. Interestingly, the US pioneered injury coding , changing our ICD-9 version to include causes of injury. Clearly the WHO ran with it in ICD-10. Fortunately, there are software solutions to speed iCD-10 coding like SpeedECoder, http://www.speedecoder.com. There’s no difference in time typing macaw than dog when someone comes in for an animal bite.
My concern with the additon of so many codes is reimbursement. When I started in healthcare in 1996 even though we had Accident Codes we didn’t like to use them because insurance companies didn’t recongnize them or if they did they often used the codes to as an excuse not to cover the service. I do thinkg specificity is important however I hope the insurance companie do not use these changes to avoid payment of claims leaving their insured to foot the bill.
Brenda,
What benefits do you see that come from such specificity in coding?
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[…] reflect upon some rather humorous information regarding the new ICD-10 codes. Last week, I read a blog from EMR and HIPAA that made me aware of the fact that the ICD-10 code volume has expanded and now includes some […]
I loved the WSJ article and wrote a newspaper column about it — and other healthcare-related whimsies — for the Addison Independent (Vermont), archived on my blog at http://middleburyvt.blogspot.com.
Personally I like the Injury due to spaceship accident. With the advent of Virgin Galactic flights out of the Mojave spaceport, it is inevitable.
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I wouldn’t mind having that code applied to me since it meant that I went in a spaceship, had an accident and survived the accident so they could use that code on me.
The injury due to being struck by a turtle has precedents in fiction. Obviously they have read Terry Pratchett’s _Small Gods_ (in which the injury was fatal).
[…] Crazy and Funny ICD-10 Codes […]
Check out this website http://shop.icd10illustrated.com/ They had artists illustrate some of the funnier ICD-10 codes. Please don’t think of me as a S16.1XXD (pain in the neck).
Hi Rex,
I’d seen that site. Pretty creative.