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Funny Codes Exist in ICD-9 Too…And It Hasn’t Been An Issue

Posted on July 27, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was recently thinking about ICD-10 and how in many ways it’s been a punchline of jokes since there are some pretty crazy ICD-10 codes. I’ve enjoyed the crazy and funny ICD-10 codes as much as the next person (we all need a good laugh on occasion), but I think it’s generally been bad for the move of ICD-10. Now that I think ICD-10 will not be delayed again, ICD-10 is no joke.

With that in mind, I wanted to put the funny ICD-10 code discussion to rest. So, I asked on Twitter if there were any “funny” ICD-9 codes (of course if you have any of these things, it wouldn’t be too funny). In response to my tweet, Jennifer Della’Zanna created this great post that puts the “funny” ICD-10 codes in perspective. She also provided me this list of ICD-9 codes that could possibly be considered funny codes as well:

E928.4 External constriction caused by hair
E918 Caught accidentally in or between objects
E005.1 Injury from activities involving yoga
E913.3 Accidental mechanical suffocation by falling earth or other substance
E018.2 Injury from activities involving string instrument playing
E827.4 Animal drawn vehicle accident injuring occupant of streetcar
E845.0 Accident involving spacecraft injuring occupant of spacecraft
E905.4 Centipede and venomous millipede (tropical) bite causing poisoning and toxic reactions
E917.7 Striking against or struck by furniture with subsequent fall
E927.1 Overexertion from prolonged static position
E927.2 Excessive physical exertion
E928.0 Prolonged stay in weightless environment

You could see a nice sticker with a picture for E905.4 as a centipede bite, that’s funnier than the full description. That’s what’s happened with many of the ICD-10 codes that are made into jokes. However, that misses my point. My point is that we’ve had some funny ICD-9 codes for a long time and it’s never been an issue. The ICD-10 codes that have been made into jokes won’t be an issue either. It’s time to move on to the ICD-10 codes that do matter and make sure we’re ready for ICD-10 come October 1st.

Funny ICD-10 Codes Have Ruined the ICD-10 Branding

Posted on October 17, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The people at online physician community, QuantiaMD, recently sent me a list of the top 3 “Crazy ICD-10 Codes” that they got from their community. It was quite interesting to learn that when they asked their community for these codes, they yielded double the participation the company typically sees. No doubt, physicians have globbed on to these funny and crazy ICD-10 codes. I’ll be honest. I’ve gotten plenty of laughs over some of the funny ICD-10 codes as well. Seriously, you can’t make some of this stuff up. Here’s a look at the top 3 crazy ICD-10 codes they received (and some awesome color commentary from the nominators):

1. W16.221 – Fall into bucket of water, causing drowning and submersion. I didn’t realize mopping the floor was so dangerous!
2. 7. Z63.1 – Problems in relationship with in-laws. Really, Who does not?
3. V9733xD – Sucked into jet engine, subsequent encounter. Oops I did it again.

While these codes are amazing and in many respects ridiculous, they’re so over the top that they’ve branded ICD-10 as a complete joke. For every legitimate story about the value of ICD-10 there have probably been 10 stories talking about the funny and crazy ICD-10 codes. You can imagine which story goes viral. Are you going to share the story that talks about improvement in patient care or the one that makes you laugh? How come the story about their being no ICD-9 code for Ebola hasn’t gone viral (Yes, ICD-10 has a code for Ebola)?

Unfortunately, I don’t think the proponents of ICD-10 have done a great job making sure that the dialog on the benefits of ICD-10 is out there as well. Yes, it’s an uphill battle, but most things of worth require a fight and can easily get drowned out by humor and minutiae if you give up. If ICD-10 really is that valuable, then it’s well worth the fight.

My fear is that it might be too late for ICD-10. Changing the ICD-10 brand that has been labeled as a joke is going to be nearly impossible to change. However, there are some key people on the side of ICD-10. CMS for starters. If you can get the law passed, then the ICD-10 branding won’t matter.

One thing I do know is that doing nothing means we’ll get more and more articles about Funny ICD-10 codes and little coverage of why ICD-10 needs to be implemented. I encourage those who see the value in ICD-10 to make sure their telling that part of the story. If you don’t have your own platform to share that part of the story, I’ll be happy to offer mine. Just drop me a note on my contact us page.

Why Do People Find ICD-10 So Amusing?

Posted on April 2, 2014 I Written By

In case you missed the news, ICD-10 has been delayed a year. It’s likely that we’ll be taking a break from talking about ICD-10 for the next 6-10 months. However, before we put ICD-10 on the shelf, you might want to read two opposing arguments for and against ICD-10: The Forgotten Argument For ICD-10 and Why ICD-10? Plus, below is a guest blog post by Heidi Kollmorgen, Founder of HD Medical Solutions, putting some perspective on where we’re at with coding. She has some good insights I hadn’t heard before. I’ll probably wrap up this series on ICD-10 with a look at what organizations should do now that ICD-10’s been delayed.
Heidi Kollmorgen
Many people who don’t understand the value of ICD-10 go straight to the “humorous codes” as a reason to justify delaying its implementation or even not adopting it at all. Does anyone realize those codes only make up 67 of the 1583 pages of the 2014 Draft Set?

Those seemingly “useless” codes are stated in the ICD-10 Chapter 21 Guidelines as having “no national requirement for mandatory ICD-10-CM external cause code reporting”. External Causes of Morbidity codes “are intended to provide data for injury research and evaluation of injury prevention strategies” only.

The *real* ICD-10 codes are more specific and allow greater accuracy for clinical data purposes. Many would agree that patient safety and effective and timely patient-centered care are the goal of most healthcare providers. Clinical data gathered and analyzed is what allows this to be achieved and ICD-10 codes are critical for more accurate analysis (1).

ICD-9 was adopted and went “live” in 1979 – how many advances has medicine made since that time? The ICD-9 code set does not allow doctors to accurately identify how they are treating patients any longer, nor does it allow accurate reporting of the services they provide to their patients. In 2003 the NCVHS recommended the adoption of ICD-10 and fourteen years later providers still claim they haven’t had time to prepare (2).

Doctors and other healthcare professionals who choose to take advantage of the daily barrage of free ICD-10 training and education from CMS and countless other sources for themselves and their staff will not go out of business. Providers who recognize that hiring an educated and/or certified medical biller/coder is an investment with huge ROI potential.

Those individuals have the training and ability to prevent and decrease denials and rejected claims from the onset when the claims are initially prepared. They also understand the intricacies of carrier guidelines so providers who hire them will never go out of business or suffer from decreased cash flow, rather their reimbursement would improve and they would also be compliant.

The days of hiring your neighbors daughter or friend because they need a job, or because they like working with numbers are over. It shouldn’t be impossible to understand how saving money in overhead and payroll only costs you infinitely more in lost reimbursement. Is the irony lost in correlating the profession of Health Information Management to Nursing? In the history of medicine it was only in the last one hundred or so years that licensing of nurses went into law. http://www.nursingworld.org/history Would any doctor today work with an unlicensed or inexperienced person who claimed to be a nurse? Would any hospital or facility hire someone who applied for a nursing position only because they liked working with people? That’s basically how the profession of nursing began.

In regards to the opinion held by many how ICD-10 codes are outlandish I would agree in some cases. I have a wicked sense of humor and because I know the codes I could create funnier cartoons than any you have come across. The difference is that coders understand how that argument holds no merit and only proves how providers don’t even understand ICD-9-CM. Unfortunately, most are probably using it incorrectly as well and it may be one of the causes of low reimbursement.

Just in case you see a patient today who is a water skier and has an accident while jumping from a burning ship use ICD-9-CM E8304. Have a patient who was knocked down by an animal-drawn vehicle while riding a bike? There’s a code for that too – ICD-9-CM E827.

The good news is how the Guidelines for ICD-9-CM patient encounters are similar to ICD-10-CM for these types of codes. If you don’t typically use them now you won’t when ICD-10 goes into effect either. Providers who document what they did, why they did it and what they plan to do do about it will have no problem switching to ICD-10. Aren’t we lucky nothing has changed about that?

Heidi Kollmorgen is the founder of HD Medical Solutions which offers practice management services for solo and multi-physician groups. She holds AHIMA certifications and is dedicated to optimizing reimbursement by following compliant measures. She can be found at http://hdmedicalcoding.com/ or follow her on Twitter @HDMed4u.