There are 68,000 billing codes under the new ICD-10 system, as opposed to a paltry 13,000 under the current ICD-9. The expansive diagnostic codes, intended to smooth billing processes and assist in population health and cost reduction across the healthcare delivery system, have providers across the board worried about integration: A recent survey by the American Health Information Management Association and the eHealth Initiatives found that 38% of providers think revenue will decrease in year following the switch from ICD-9, while only 6% think revenue will increase.
Still, providers are preparing for the switch. After yet another delay this year, the official changeover date is set for October 1, 2015, and 40% of respondents say they will be prepared to do end-to-end testing by the end of this year.
Despite the controversy surrounding ICD-10, there is one universally agreed-upon upside to the hyper-specific coding system: Weird and obscure codes that stand for bizarre medical injuries. There's even an illustrated book, Struck by an Orca: ICD-10 Illustrated. (Healthcare Dive is super into it.)
Therefore, behold! The 16 most absurd codes in the entire ICD-10 set, with a little advice from Healthcare Dive on how to handle these cases should they come into your ER:
16. V97.33XD: Sucked into jet engine, subsequent encounter.
Sucked into a jet engine, survived, then sucked in again? First of all, that really, really sucks. Second of all, this patient is obviously Wolverine, and should be detained for imaging and posterity.
(Technically, this means "subsequent encounter with a physician" not "subsequent encounter with a jet engine," but that's less dramatic.)
15. W51.XXXA: Accidental striking against or bumped into by another person, sequela.
The "sequela" here implies the kind of human bumper cars that can only happen at a music festival, the subway or possibly an active combat zone. Potentially fatal for agoraphobics. Recommend handling with care.
14. V00.01XD: Pedestrian on foot injured in collision with roller-skater, subsequent encounter.
First, are roller skates even still a thing anymore? I mean, other than how one knows spring has sprung in Central Park? Second, can you call a person on roller skates a pedestrian? Thirdly, if the answers to one and two are "yes," then these things should be outlawed, because they are obviously dangerous.
13. Y93.D: Activities involved arts and handcrafts.
Camp is a dangerous thing. Hot glue guns and knitting needles definitely wouldn't be allowed on a plane, yet we habitually allow 7-year-olds to play with them. This is a public health crisis that needs to be addressed.
12.Z99.89: Dependence on enabling machines and devices, not elsewhere classified.
There's a reason they call it the Crackberry. This is an obsolete joke, but there just isn't an iPhone pun that can compete with "crackberry."
11. Y92.146: Swimming-pool of prison as the place of occurrence of the external cause.
There is also a code for "day spa of prison as the place of occurrence."
10. S10.87XA: Other superficial bite of other specified part of neck, initial encounter.
Alright, people. Let's call a spade a spade. "Other superficial bite of other specified part of the neck?" This is a hickey. Admit it. Although why anyone would be admitted for that remains a mystery.
9. W55.41XA: Bitten by pig, initial encounter.
First, be sure that the patient is restrained from doing whatever he or she may have done to provoke the pig in the first place. Security should be placed on alert. Also, what was this person doing in a farm setting in the first place? Pigs are not pets.
8. W61.62XD: Struck by duck, subsequent encounter.
Maladies that rhyme should be given immediately priority in the ER. Ducks, like most water fowl, are mean-spirited animals and this case should be treated with the utmost urgency as it is likely to be a serious injury.
7. Z63.1: Problems in relationship with in-laws.
6. W220.2XD: Walked into lamppost, subsequent encounter.
No. No. People. You only get to do this once. ONCE. If a patient is going around whacking into lampposts regularly, there is a deeper problem here, and he should be referred to psych immediately.
5. Y93.D: V91.07XD: Burn due to water-skis on fire, subsequent encounter.
How does this happen? Are water skis even flammable?
4. W55.29XA: Other contact with cow, subsequent encounter.
"Other contact with cow." OTHER CONTACT WITH COW? There are codes for "bitten by cow" and "kicked by cow." What else is there?! What, precisely, is the contact with the cow that has necessitated a hospital visit?!
3. W22.02XD: V95.43XS: Spacecraft collision injuring occupant, sequela.
The existence of this type of code does not engender trust in the National Aeronautics and Space Administration. Shouldn't they have more control over their spacecraft than that? Or are they just careening around in the ether, pinging into one another and injuring occupants/astronauts?
2. W61.12XA: Struck by macaw, initial encounter.
Macaws are endangered—some are extinct in the wild—so if a patient has been struck by a macaw, chances are, it was the patient's fault. Consider calling the SPCA and/or the police. The macaw needs to be found and treated immediately.
1. R46.1: Bizarre personal appearance.
LADY GAGA, IS THAT YOU? WE LOVE YOUR MEAT SUIT.
But seriously, who gets to decide what constitutes "bizarre personal appearance"? Let the people do what they want!
Did we miss one? Tweet us your favorite bizarre code at @healthcaredive. And check out our ICD-10 coverage. You may also want to read about the ongoing development of ICD-11, or visit our GIF guide to the most important animal ICD-10 codes.
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