Ch-ch-changes (In Coding)

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Recently, I’ve been in the middle of a complicated, interesting, and frequently confusing process called “transitioning from ICD-9 to ICD-10”. There are many challenges and roadblocks, but the success and “Aha!” moments, plus the hilarious codes I’ve found as I search through our new coding book, make a huge difference as we figure this new system out.

A bit of history for you: the ICD coding systems are a way for doctors to diagnose conditions in patients. In the mid-seventies, the ICD-9 system was adopted, but as more and more possible diagnoses were accepted, there weren’t enough codes to accommodate the needs for specificity. Thus, ICD-10 was introduced. It’s been around for a few years, but it wasn’t mandated for us to implement it until October of 2014. There was, however, an extension, so our deadline was pushed back to October 1st, 2015. That leaves us with just four months to finish preparing for the switch over!

ICD-10 has over 90,000 codes, but that’s for all branches of medicine. Thankfully, we only have to deal with a little under 3,000. I never thought I would say “only” and “3,000” in the same sentence, but there you go! For the last few weeks, I’ve been investigating and starting the switch to the new coding system, starting with a few webinars and downloading the new database of codes into our software. After a bit of studying, the new system started to make sense, but then came the real challenge: finding what ICD-9 codes we use that translate over to more precise ICD-10.

ICD10 coding

If you were wondering, my diagnosis coding would be G44.229 – chronic tension-type headache, not intractable (meaning I can get rid of it). Thanks, ICD-10!

But here’s the real fun…

When you’re tackling a big challenge like this, no matter how fun the task may be, you still need a bit of levity to make things easier! Sherry and I have found a few codes that have made us laugh, either by the strangeness or just the very specific notation. Here are just a few:

  • Bitten by a duck – W61.61XA
  • Burn due to water skis on fire – V91.07XA
  • Walked into lamppost – W22.02XA
  • Problems in relationship with in-laws – Z63.1
  • Type A behavior pattern – Z73.1
  • Bizarre personal appearance – R46.0

When they say specific, they really mean it!

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