ICD-10 Oddities

On October 1, Medicare switched from ICD-9 to ICD-10 diagnosis coding.  As a researcher, I appreciate that ICD-10 will give a much more granular representation of a disease.  However, the risk is that the level of granularity is so fine that the administrative costs on providers becomes high.  Some of the diagnose codes, in fact, seem downright odd.  Below are a list of some of the odder ICD-10 codes.

1. R46.1: Bizarre personal appearance. Of all the crazy codes, this has to be one of our favorites. We’re not exactly sure what constitutes a person’s appearance as “bizarre.” That’s the doctor’s call. Most of Lady Gaga’s outfits are pretty bizarre, but that may not count as a medical condition (or maybe it does).
2. V91.05XA: Burn due to canoe or kayak on fire, initial encounter. It’s difficult to imagine that a vehicle immersed in a body of water could catch on fire but, apparently, it happens.
3. W16.222D: Fall in (into) bucket of water causing other injury, subsequent encounter. The picture that comes to mind is a daredevil high-diver plummeting from a 100-foot platform at a circus. It’s pretty much a given; some injury is bound to occur.
4. W22.01XA: Walked into wall, initial encounter. Let’s face it. We all have those days when we just can’t find the door, right?
5. W22.02XD: Walked into lamppost, subsequent encounter. Walking into a wall is one thing, but walking into a lamppost? And by “subsequent,” are we suggesting that this isn’t the first time it’s happened? (Yes, we know this means a subsequent encounter with a physician, but don’t spoil the fun, okay?)
6. W53.21XD: Bitten by squirrel, subsequent encounter. Maybe the patient thought it was their cat? Prescription: get an eye exam.
7. W55.42XA: Struck by pig, initial encounter. Heaven knows we don’t want our patients to suffer subsequent pig-striking encounters. One is bad enough.
8. W59.29XS: Other contact with turtle, sequel. It’s a given that most contacts with turtles don’t result in injuries. But if the initial “other” type of contact was epic, certainly, it deserves a sequel.
9. W56.29XD: Other contact with orca, subsequent encounter. We can’t imagine any contact with an orca would turn out well, much less a subsequent one.
10. Y92.131: Mess hall on military base as the place of occurrence of the external cause. We all know high school and college cafeterias serve “mystery meat.” Perhaps military mess halls do as well.
11. V95.42XD: Forced landing of spacecraft injuring occupant, subsequent encounter. NASA might have something to say about this. But, honestly, what doctor wouldn’t want to treat Buzz Aldrin?
12. V80.731A: Occupant of animal-drawn vehicle injured in collision with streetcar, initial encounter. This could happen — were it the 1890s! Which makes us wonder, is there an ICD-10 code for “Uber-driver injured in collision with taxi?”
13. Y92.834: Zoological garden (Zoo) as the place of occurrence of the external cause. Make certain not to stick your finger in the macaw cage. (And, yes, there’s a code for injury resulting from an encounter with a macaw: W61.11XD.)
14. Y92.311: Squash court as the place of occurrence of the external cause. Better to play racquetball; the racquets are shorter. Tennis is even better. At least there players are separated by a net.
15. Y92.146: Swimming pool of prison as the place of occurrence of the external cause. One has to imagine there are much more dangerous places where a prisoner is likely to get injured than a swimming pool.
16. Y93.D1: Activity, knitting and crocheting. Anything involving needles can result in injury. And who has time to crochet anyway?
17. W27.4XXD: Contact with kitchen utensil, subsequent encounter. Injury by spoon?
18. V97.33XD: Sucked into jet engine, subsequent encounter. Birds getting sucked into a jet engine we understand, but a person? (The encounter itself definitely isn’t funny, but we’re talking about ICD-10 codes. And you have to admit, this one is.)
19. W61.62XD: Struck by duck, subsequent encounter. Anyone who has ever taken a stroll by a lake in a public park can relate to this encounter, which is why you should have insurance from Aflac.
20. Y92.72: Chicken coop as the place of occurrence of the external cause. This is what happens when you attempt to get an egg from under a hen with a bad attitude.