Strange codes from the International Statistical Classification of Diseases and Related Health Problems

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Good thing we have well-trained doctors to do all that data entry for us.


But what if you are injured while watching an opera on a spacecraft, in a scene that uses a jet engine as a prop that accidentally sucks you in from the audience, twice?


The ICD-10 is proving to be a real pain in the ass because there are incident codes for “Vaccine related injuries.”

Because it exists, the anti-vaxxers are going nuts, saying it must be common.

Of course there is also a code for “Patient stole syringe and injected self”


Sure the spacecraft things seem funny, but I suspect that astronauts injure themselves at a higher-than-usual rate (not even counting catastrophic equipment failures like Challenger or Columbia), and every single such injury is eligible for workman’s compensation. Seems like having one or two diagnostic codes to say “no this really happened in space” isn’t a bad idea.


I used to have fun with these back when I was a coder, but that was in the ICD-9 years. (The entire U.S. medical industry transitioned to a new diagnosis coding system in 2013-2015.) My favorite code from back then was E996.x, Injuries sustained in nuclear war. I looked it up, seems like it maps to Y36.x in ICD-10.

Doctors don’t directly select diagnosis codes. They chart procedures and diagnoses that are then coded by a certified coder before submitting to the payer.


V95.43(b) (“Andromeda Strain Event”)


And doctors will tell you that these idiotic codes are a business-killing expensive nonsense. They have to hire additional help JUST to figure out which codes to use on patient records. That is a full-time job because it’s such a complex set, and it actually makes it longer and harder for doctors to get paid on insurance or Medicare/Medicaid claims, because the offices liable for the payment give them endless arguments over using the “wrong” codes on the submitted paperwork. These codes have NOTHING to do with healthcare quality control. Their real purposes are to make it easier for non-medical personnel to do data mining, and to make it harder for doctors to get paid thus protecting the insurance companies’ profit margins. And for that purpose they are working exactly as designed.




I work with Medicaid claims data daily. The vast majority of these codes are never used.

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Probably not those doctors in academic centers, for-profits, and multi-specialty corporations, but I can assure you that many (most? all?) of those on the front line of community medicine still do. Sadly.


I’m a nice guy but that’s just… no. First, the overhead from coding and record keeping is included in the Professional Expense portion of the payment, and paid separately from the compensation for the provider’s work, at a rate determined (mostly) by the American Medical Association.

ICD-10 provides a consistent, comprehensive set of terminology to communicate the diagnosis for which a patient was treated. That’s essential to the entire healthcare system, regardless of the payment model. It drives decision support systems, real-time medical error checking, preventive care recommendation, and almost everything else we do.

Of course payers (including public and non-profit payers) need providers to submit a diagnosis to justify the procedure that was performed. The vast majority of claims are adjudicated and paid automatically based on that data.

And how could we improve quality of care or research anything if we don’t record who is diagnosed with what?


Wow, I had to look that one up. It’s meant to convey gravy, right?

What’s so strange about the jet engine codes? Sucked in doesn’t mean your whole body was sucked in, it could be just a limb. A traumatic amputation but if you got a tourniquet fast enough you could live.

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True in large practices and institutions. In our practice, yes, the docs directly enter the coding. Of course, we use a computerized system, so it is not totally random, but ICD-10 is a pain in the ass.


And yes, this exactly.

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Came for V91.07XA ( Burn due to water-skis on fire, initial encounter), now disappointed.

Meanwhile, my day job involves using ICD10 death codes to look at the geographic distribution of opioid related overdose deaths and is there a consistent way to code this, the single largest cause of accidental death in the United States? Why no, there’s not, and coroner/medical examiners across the country all have their own pet ways to code it… [/fume]

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Re: Y92.253 (“injuries sustained at the opera”)

One of my second cousins was an opera singer (now retited) and he was in two freak accidents on stage. The one time he broke another singer’s leg, the other time he stabbed one.


Multiple codes can be applied to the same injury (I work for a healthcare company)

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