Wednesday, September 30, 2015

And You Didn't Know There Was Such Comic Potential in ICD-10 Codes

My son-in-law is a social worker, and has to keep up on ICD codes, used for billing insurance companies and also for categorizing causes of death (which is why I care about them).  This article is very funny:

There are 68,000 billing codes under the new ICD-10 system, as opposed to a paltry 13,000 under the current ICD-9. The expansive diagnostic codes, intended to smooth billing processes and assist in population health and cost reduction across the healthcare delivery system, have providers across the board worried about integration: A recent survey by the American Health Information Management Association and the eHealth Initiatives found that 38% of providers think revenue will decrease in year following the switch from ICD-9, while only 6% think revenue will increase....

Despite the controversy surrounding ICD-10, there is one universally agreed-upon upside to the hyper-specific coding system: Weird and obscure codes that stand for bizarre medical injuries. There's even an illustrated book, Struck by an Orca: ICD-10 Illustrated. (Healthcare Dive is super into it.)

Therefore, behold! The 16 most absurd codes in the entire ICD-10 set, with a little advice from Healthcare Dive on how to handle these cases should they come into your ER:

16. V97.33XD: Sucked into jet engine, subsequent encounter. 

Sucked into a jet engine, survived, then sucked in again? First of all, that really, really sucks. Second of all, this patient is obviously Wolverine, and should be detained for imaging and posterity.
(Technically, this means "subsequent encounter with a physician" not "subsequent encounter with a jet engine," but that's less dramatic.)...

13. Y93.D: Activities involved arts and handcrafts. 

Camp is a dangerous thing. Hot glue guns and knitting needles definitely wouldn't be allowed on a plane, yet we habitually allow 7-year-olds to play with them. This is a public health crisis that needs to be addressed.

11. Y92.146: Swimming-pool of prison as the place of occurrence of the external cause.

There is also a code for "day spa of prison as the place of occurrence."

8. W61.62XD: Struck by duck, subsequent encounter.

Maladies that rhyme should be given immediately priority in the ER. Ducks, like most water fowl, are mean-spirited animals and this case should be treated with the utmost urgency as it is likely to be a serious injury.

7. Z63.1: Problems in relationship with in-laws. 

Who doesn't?

6. W220.2XD: Walked into lamppost, subsequent encounter. 

No. No. People. You only get to do this once. ONCE. If a patient is going around whacking into lampposts regularly, there is a deeper problem here, and he should be referred to psych immediately.

5. Y93.D: V91.07XD: Burn due to water-skis on fire, subsequent encounter​.

How does this happen? Are water skis even flammable?

4. W55.29XA: Other contact with cow, subsequent encounter.

"Other contact with cow." OTHER CONTACT WITH COW? There are codes for "bitten by cow" and "kicked by cow." What else is there?! What, precisely, is the contact with the cow that has necessitated a hospital visit?!


  1. I'm guessing millions and millions of medical records were analyzed in order to narrow it down to 68,000. Which is fine until someone comes in with medical problem 68,001. At which point the computers crash and a state of emergency is declared.

    I guess this is healthcare "reform."

  2. Perfect example of a regulatory state gone completly out of control.

  3. Well, for 4.W55.29XA, the patient could have been Gored in addition to being bitten or kicked. Had the patient been "Clintoned", that could be classified as a bite or once again, "other".

  4. @Windy,

    I presume that "other contact with cow" would include being crushed between a cow and a wall...

  5. I knew someone who was severely injured after hitting a duck at high speed while riding his motorcycle.

    Here is a video of someone water skiing with the ski's on "fire"