We’re sorry, this disease is unlisted

By now most people have had the disconcerting experience of having some medical procedure or other deemed Not Covered because the physician didn’t enter a code that passed muster with the insurance company. Dr. B used to say that “I could either know billing or know medicine.” But now there’s a whole new set of codes:

Physicians have gotten a few laughs from the new and voluminous set of diagnostic codes known as ICD-10, which distinguishes between being struck by a duck (W6162XA) and being bitten by a duck (W6161XA).

[Insert “quack” joke here.]

The new codes were required as part of HIPAA. As it happens, ICD-10 is five times the size of the old ICD-9, and it’s not so hard to see why:

ICD-9, for example, recognizes that patients may seek treatment because they were bitten, and gives clinicians a few choices, such as dog, rat, snake, arthropod, unspecified animal, or human.

ICD-10, in contrast, is a veritable zoo of bite codes — horse, cow, cat, pig, shark, dolphin, sea lion, alligator, macaw, parrot, and duck, to name just a few new kinds of jaws. And for each kind of bite, physicians can pick a code for an initial encounter, subsequent encounter, or sequela.

And from the Just Try to Top This file:

Some accident codes, however, defy the imagination, such as the famous V9107XA: burn due to water-skis on fire, initial encounter.

But there’s still no code for being turned into a newt, or for recovery therefrom.





2 comments

  1. McGehee »

    6 November 2011 · 6:25 pm

    So what’s the ICD-10 code for brain damage suffered as a result of having ICD-10 fall on your head, as opposed to the brain damage that was necessary to be able to write ICD-10?

  2. Charles Pergiel »

    8 November 2011 · 12:08 am

    Methinks somebody in the ICD-10 writing shop is having fun, which will be quashed as soon as anyone figures it out.

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