coding, humor, insurance, medical billing, medicare

ICD-10 Crazy Codes

Medical coding.  It’s an entirely separate language that distills all medical problems down to a “code.”  Currently, ICD-9 is in use.  Every time you receive medical care, your diagnosis is translated to a code which is then used for billing purposes, among other things.   Your hypertension and high cholesterol? 401.9 and 272.4.  Your hypothyroidism? 244.9.

And so on.

ICD-10 is going into effect next year.  It will increase the number of possible codes from 17,000 to 141,000.  No potential for confusion or complications there.

Now, has medical practice become so much more complicated over the past 30 years that there are now 124,000 new diagnoses?  Of course not.  ICD-10 is just more specific than ICD-9.  Much more specific.

For example, if you were to present to your doctor now after getting bit by, say, a squirrel, the code would be E906.3 (bite of an animal other than an arthropod).  But under ICD-10, your doctor can actually code that it was a W53.21XD (bitten by squirrel) to make sure that it is not confused with a W55.42XD (bitten by pig).

Or, after that ill-conceived ocean swim, your doctor can bill appropriately for W56.01XD (bitten by dolphin) vs W56.11XD (bitten by sea lion) vs. W56.21XD (bitten by orca).

Do you see the importance of these distinctions??

There are other codes that I’m sure are crucial.  V9733XD (sucked into jet engine, subsequent encounter).  Got that?  Subsequent encounter.  They made a code to cover someone who got sucked into a jet engine, not once, but twice.


NO CAPES!!!


For those of you that worry about worst-case scenarios, there are also codes for you.  For example- T71224A (asphyxiation from being trapped in a car trunk).  This is to be distinguished from T71234A (asphyxiation from being trapped in a discarded refrigerator).  There are also codes to clarify if the fridge asphyxiation was accidental, assault, attempted suicide, or “undetermined.”  If you’re really unlucky, you might have to use V9020xA (drowning or submersion due to falling or jumping from a burning merchant ship- initial encounter).

By the way, I apologize for any typos.  I have a big bandage on my index finger, having done a W920xxA this morning (contact with powered kitchen appliance).

Actually, there’s one ICD-10 code that probably covers this whole coding thing quite nicely- K62.89 (pain, anus).

2 thoughts on “ICD-10 Crazy Codes”

  1. ICD-10 seems to be more about easy data collection for CMS and insurance companies than actually improving care. Quite sure that coding that specifies trunk v. refrigerator doesn't have a heck of a lot of impact on the patient's medical care (unless it's getting short-changed because the doc has to spend so much time finding the right damned code that there's no time left to actually DO the patient care).

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  2. Jokes aside, implementing ICD is rumored to cost over 100K per physician, and that will surely not include the training and addtiion of special new coders and posters, adding cost, burden, bureaucracy, and inefficiency to an already overstressed healthcare system. Between the lawyers, the governement, the insuraance companies, healthcare if there is even any care left, is becoming a farse.

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