According to this report, a doctors’ group in Alabama is protesting the not-yet-implemented ICD-10 medical-coding system by ridiculing it, an approach that I certainly endorse. See, e.g., “Injury Code W59.22XA: Struck by Turtle,” Lowering the Bar (Sept. 13, 2011) (citing the WSJ). Given that the new system uses over 140,000 codes, and is intended to be über-comprehensive, there are plenty of potential favorites to choose from.
The CDC says ICD-9, used since 1979 and boasting a mere 18,000 codes, is simply “not sufficiently robust to serve the health care needs of the future.” While, for whatever reason, “robust” is one of those words that makes me want to punch someone, I am willing to accept that additional codes may be needed as time goes on. At the moment, I am thinking mainly of the 122,000 ways I am likely to die from Ebola—efforts to contain which are currently underway in a state run by Rick Perry—but there could be many other necessary codes that ICD-9 just did not contemplate.
But there are at least some we are not at all likely to need.
This is partly because, as we learned in connection with the turtle codes (also the armadillo controversy), the same options are often repeated for multiple categories, whether or not they fit each individual item. This appears to be how we got “struck by turtle”—certainly you could be “struck by bear” or “struck by bird,” so let’s just apply these down the line to all animals. Well, but it’s probably safe to leave that out of the turtle section, since cases in which a turtle has accelerated to a dangerous speed are really pretty rare.
This is presumably also how we get V97.33XD, “sucked into jet engine, subsequent encounter.” Which, as the doctor’s group points out, is a code we could probably manage without. They point to this as one of many unnecessary codes that doctors will now have to sort through. “That being said,” one of their lobbyists conceded, “for the guy unlucky enough to get sucked into a jet engine more than once, there’s a code for that.”
I noted the “sucked into jet engine” code previously, but somehow failed to mention the “subsequent encounter” sub-code. So credit is due for that. (Under ICD-9, this would have been “other specified air transport accidents,” which seems fine.) I am still a big fan of V96.15 (“hang-glider explosion”), W58.13 (“crushed by crocodile”), and X74.02 (“intentional self-harm by paintball gun”), but will also give the doctors credit for noticing V98.2 (“accident to, on or involving ice yacht”), and Z63.1 (“problems in relationship with in-laws”). Though I guess the latter may not be that uncommon.
I see nothing funny, however, about W22.02 (“walked into lamppost”), having done that once myself as I have admitted here previously. This code is plainly necessary given the negligent placement of said lampposts and/or their sinister tendency to edge into one’s path while one is not looking. “Ebola virus disease” is covered by the new system (A98.4, just so you have it handy), and I guess I have mixed emotions that there’s not one for “Ebola virus disease contracted by walking into lamppost.” Already looking forward to ICD-11.
Again, with more than 140,000 codes and subcodes, there is very likely more good stuff in there. If you want to search it yourself, this site is a good option.
Good luck out there.
Update: I am informed that in these codes, “encounter” (as in “subsequent encounter”) refers to a doctor’s visit, not an accident, although that seems like an awfully strange word to use for a meeting between doctor and patient. I can see “encountering” a bear, but normally I see my doctor on purpose. In any event, at least in the case of the jet engine, there is not going to be a second doctor’s visit, either. (Or a first.)