ICD 10 finally recognizes the dangers inherent in diving !!!!

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Spent a while pursuing the new ICD 10 codes for dive related injuries and do not know whether to laugh or cry that we as tax payers actually payed someone to come up with these ridiculous codes.

For those that dont know, ICD 10 replaced ICD 9 as the official billing classification of all diseases. Essentially your doctor has to use the correct diagnosis code to be payed for his service.

A billing code for being bumped buy a turtle ??? And if that isn't bad enough the poor bumpee got back into the ocean only to be bumped a subsequent time by a turtle and now there is a second billing code for subsequent bumps !!!!

For all of those that have attended a shark feed and been bumped you will be happy to know there is now a code for the first bump and then all subsequent bumps thereafter have their own code !!!!

The best of all has to be the self inflicted stingray attack !!!! - A separate code to the accidental stingray attack

Divers please make sure to be upfront with your doctors - if you got bumped more than once they need to bill appropriately. And also if you self inflicted that stingray sting gotta make sure not to pretend it was accidental. Medicare and the whole medical community could be thrown into disarray !!!

The correct wording is STRUCK by turtle, not bumped. There's also a code for drowning or submersion related to jumping from unspecified burning water craft, and another for sucked into jet engine (subsequent encounter), not to mention pecked by chicken, bitten by duck, fall into filled bucket of water, and assault by hot household appliances. :)

---------- Post added November 23rd, 2015 at 04:28 PM ----------

In all seriousness, how are you in the medical world going to deal with this? I've been aware of this for some time since I am also in health care, but thank goodness, will not have to cope with the level of diagnostic specificity that you now have. I imagine medical offices almost having to hire an additional person whose whole job it will be to figure out EXACTLY which code it has to be for each patient. On the other hand, I suspect there are no code police, so that if you get something in the neighborhood, it will likely be okay. What's your take on it?

It's not been that bad from a hyperbaric medicine perspective. We crosswalked ICD-9 codes to ICD-10 starting about a year ago. When we went live in October, every diagnosis for every patient was converted. It was nearly seamless for our patients. Now when we input an ICD-10 code it will often "spawn" other codes in our electronic medical record system. For example, if we put in T66.XXXS (late effects of radiation) and radiation proctitis (K62.7), it will automatically generate Y84.2, which is radiotherapy as the cause of abnormal reaction, not related to misadventure at the time of the procedure. Where there was one code, now there may be 3 or 4. The carbon monoxides have gotten a lot more specific too - there used to be just one code for CO poisoning, now there are codes for the source (motor vehicle, etc) and intent (intentional, unintentional, assault, etc).

Most insurance companies have coverage determinations that will specify which ICD-10 codes they'll reimburse for, the same as it was for ICD-9. We haven't run into reimbursement issues yet, but we're not too far into it.

Best regards,
DDM
 
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What's the code for jumping from a burning water craft (jet powered), being sucked into the intake of said craft, only to be struck by a turtle while stuck in the inlet?
 
I am surprised no one has mentioned "crushed by alligator, initial encounter" W58.03XA

Falling alligators.jpg
 
The ICD 10 transition has been pretty smooth for me in Family Medicine. Interestingly, the biggest delay that we had in payment came from Medicare...which really shouldn't have surprised me.
Sometimes it is difficult extracting the necessary detail that is needed for a specific ICD-10 code.


Me: Hi Mrs. Smith, I see you have leg pain today.

Mrs Smith: Hi Doc, yes, it is acting up some.
Me: When did it start?
Mrs. Smith: When did what what start?
Me: The leg pain.
Mrs. Smith: It's not really my leg, it's my hip.
Me: WHICH hip?
Mrs. Smith: the one that hurts.
Me: Did you injure it?
Mrs. Smith: didn't I tell you it was hurting?
Me: HOW did you hurt it?
Mrs. Smith: I didn't hurt it.
Me: Did you injure it or did it just start hurting on it's own?
Mrs. Smith: I guess it started hurting on it's own....
Me: Now we are getting somewhere.....
Mrs. Smith: when it struck the ground.
Me: You fell?? When did that happen?
Mrs. Smith: Sure I fell. Haven't you fallen before?
Me: WHEN did you fall?
Mrs. Smith: Which time?
Me: The time you hurt your hip.
Mrs. Smith: Well, it really all started the first time I went dancing with my now late husband.....
Me: Arrrrgh!
Mrs. Smith: My best friend said I need back xrays....
 
Interesting that in one day, I've gotten more help on ICD 10 from ScubaBoard than I have in all these months from the insurance companies I deal with. Thanks!

totally agree


FYI, for those NOT in the medical field, subsequent encounter = follow up visit. but it is funnier to see it as a second turtle bump!
 

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