Monday, August 19, 2013

More baffling stuff about ICD-10 codes

The ICD-10 list may be inadequate.

ABC News reports an actor was hospitalized after his foot became caught in an elevator raising the stage during a performance of the Broadway show "Spider-Man: Turn Off The Dark."

As a connoisseur of ICD-10 codes, I decided to see if I could classify this injury correctly.

To my surprise, I could not.

The only codes having to do with elevators are the W303XXs Contact with grain storage elevator.

Since I had once read that the codes were originally developed in Europe, I even searched for "lift." But all I got were Y93F2 Activity, caregiving, lifting and W240XXs Contact with lifting devices, not elsewhere classified.

Contact with lifting devices, not elsewhere classified hardly seems appropriate for elevators, which are so common. People are frequently hurt on them or by falling down their shafts. All you get when you search "shaft" are hundreds of codes dealing with bones.

We know that ICD-10 has given us such gems as
V982XXA Accident to, on or involving ice yacht,
V9542XA Forced landing of spacecraft injuring occupant and
[Click on the links to read my comments about those codes.]

So how is it that there's no code for contact with an elevator? For that matter, what about injury during a Broadway show? Surely both elevator and Broadway show injuries are much more common than say V8022XA Occupant of animal-drawn vehicle injured in collision with pedal cycle.

Filippe Vasconcellos ‏(@fvguima), a Twitter follower, suggested W230XXA Caught, crushed, jammed, or pinched between moving objects, initial encounter, but it is not clear that there was more than one moving object. And the stated aim of ICD-10 is to introduce much more specificity into the codes for better tracking of things like injuries.

What we need is even more codes. Maybe we need to get going on ICD-11 sooner than we thought.


Anonymous said...

"What we need is even more codes. Maybe we need to get going on ICD-11 sooner than we thought."

Do you have a death wish Skep? ;) I know people leaving jobs because of 10 ... mention 11 and they'll hunt you down. LOL.

artiger said...

Does ICD-10 have a code for "carpal tunnel syndrome from posting on Skeptical Scalpel too often"?

Skeptical Scalpel said...

Anon, I was kidding. Don't come after me.

Artiger, they don't, but maybe they should.

Anonymous said...

Perhaps naively, I have assumed that the point of ICD coding of events is not the creation of data, rather it is the consumption. Ideally, those responsible for expanding the list of ICD codes would have kept that in mind. It certainly doesn't look like it though. What do the ICD codes get used for other than research? Surely no one plans to submit a bill based on V9027XA... or do they? I'm pretty sure any research project they may have imagined for that code isn't going to pan out.

DD said...

SS: Found in today's news--is there a code for this: Doctors remove fork from penis of 70-year-old Australian man??

Aidu, K., Chung, A., Mulcahy, M. An Unusual Urethral Foreign Body.
International Journal of Surgery Case Reports

Skeptical Scalpel said...

Anon, it is my understanding that at some point, all billing done by docs and hospitals will have to use ICD-10 codes.

DD, thanks for that link. Fork does not appear in my list of ICD-10 codes. I think they will have to add that one to the next version.

bigjimricotta said...

when the patient woke up,he said "what the fork happened."

Annie said...

Is there a code for "Breathing, Failure to"?

Skeptical Scalpel said...

I don't think so.

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