Archive for July 20th, 2014

ICD10 – Struck by a DUCK!

July 20th, 2014

For several years something called ICD-9s dominated the healthcare providers’ reimbursement landscape.  It’s how they get paid for treating their patients.  There were 13,000 different categories of ICD-9s that were always up for individual interpretation.   Well, as only they can do, the federal government has simplified the decision-making process by complicating things exponentially.  Now, instead of the traditional 13,000 choices, there will be something called ICD-10s with 68,000 billing codes.  Over five times more obscure, yet descriptive, billing selections for the already confused healthcare workers to decipher.

The implementation of these expansive diagnostic code changes will take place in October, 2015.  Katie Bo Williams of Healthcare DIVE News wrote a wonderful description of the  most absurd codes that will be a part of the ICD-10 list, and some of them were stupid enough to have some fun with here.

A few years ago, when the codes were beginning to appear in writing for the first time, I was working in Florida and was having lunch with a group of very Southern individuals.  I jokingly said, “You know there will be a billing code for getting hurt while riding on the back of a hog.”  One woman looked almost indigently at me and said, “You’re obviously not from the South.  Our hog races are very important to us.” To this day, I’ve never seen hog jockeys!  (Bucket list.)

W55.41XA:  Bitten by a pig, initial encounter.    Let me be perfectly clear.  This code absolutely is referring to a farm-related injury.   Because my farming experience has been pretty much limited to geese who bite and cows with limited denture capabilities for significant biting, I can’t personally respond as to how risky pigs can be if aggravated.  I think it’s interesting, however, that I already have two pig references and we still have several hundred more words to go.  Does this imply that, not unlike our schools, airports, and other public buildings, we’re going to have to have armed guards to protect us in our pig pens?

One of the fantastic code descriptions that Katie writes about is V9733XD:  Sucked into a jet engine, subsequent encounter.    It took a minute for this one to sink in because I read it as, “If you happened to have been sucked into a jet engine and lived and then were sucked in again, there was now a code for it.”  In the vernacular of the times, that would really suck.  She went on to explain, however, that it meant subsequent encounter with a physician, not a jet engine.

Z63.1: Problems in relationship with in-laws.   Truthfully, I can’t believe they didn’t have this one in the first 13,000 codes.  If you’re a fan of “Sons of Anarchy” it’s certainly clear why this needs to be a code.  Who hasn’t had this challenge?

Two or three years ago, one of my doctor buddies used this next one in a speech he was giving regarding reimbursements and what was coming our way.  Y93.D: V91.07XD:   Burn due to water-skis on fire, subsequent encounter.  A person has to ask, “What could you possibly have done to even get your water skis to catch on fire?  Did you soak them in a flammable liquid for two days?  Did you jump through a burning hoop on skis?”  In that case there should be a code for flaming Speedos.

12.Z99.89: Dependence on enabling machines and devices, not elsewhere classified.   This one obviously refers to a physician having to counsel us because of our addictions to electronic communication devices.   As Katie says, “There’s just no substitute for a Crackberry.”

Finally, my very favorite one is W61.62XD: Struck by a duck, subsequent encounter.    It’s my favorite for reasons that I can’t really write about here relating to a really old joke, but it is one of the only codes that rhymes.  He was struck by a duck!   Get him to the ER. STAT!