# ICD-10.  A new endurance test for doctors

**URL:** <https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295>\
**Category:** Miscellaneous and Personal Stuff I Must Share\
**Created:** [July 27, 2015, 3:45am UTC](https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295 "2015-07-27T03:45:30Z")\
**Posts on this page:** 13\
**Page:** 3

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**Author:** ![Shagnasty](https://avatars.discourse-cdn.com/v4/letter/s/9dc877/32.png) [@Shagnasty](https://boards.straightdope.com/u/Shagnasty)\
**Post date:** [July 29, 2015, 3:02am UTC](https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295/41 "2015-07-29T03:02:42Z")

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I can’t express confidence in this new system at all. As far as I can tell, they cover most things for the first or second incidents but not for the subsequent ones. What about when my pet chinchilla bites me for the 5th or 6th time? Does that mean the tip of my fingernail cannot be restored by a specialist? My insurance would hopefully cover a really qualified Vietnamese manicurist because they are the best. I wouldn’t ever want to lose that option for healthcare service providers.

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**Author:** ![ITR\_champion](https://avatars.discourse-cdn.com/v4/letter/i/c67d28/32.png) [@ITR\_champion](https://boards.straightdope.com/u/ITR_champion)\
**Post date:** [July 29, 2015, 4:07am UTC](https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295/42 "2015-07-29T04:07:46Z")

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> [@F.Pu-du-he-pa-as](#):
>
> Oh my gosh. Now I’m imagining some action movie where these codes and the text of what they represent are read out any time a character gets hurt. That would be awesome.

I’m imagining ICD-10: The Game, where the player attempts to dodge falling alligators, attacking chickens, exploding wheelbarrows, and other such menaces.

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**Author:** ![Inigo\_Montoya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/inigo_montoya/32/124_2.png) [@Inigo\_Montoya](https://boards.straightdope.com/u/Inigo_Montoya)\
**Post date:** [July 29, 2015, 2:07pm UTC](https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295/43 "2015-07-29T14:07:44Z")

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> [@Czarcasm](#):
>
> I can’t find the code for “Knocked into rabid porcupine by windmill”.

Is there even a feasible way for a critter to give rabies to a porcupine?

Also, I did not know until just now: Porcupines are rodents. Huh.

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**Author:** ![Indyellen](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/indyellen/32/4176_2.png) [@Indyellen](https://boards.straightdope.com/u/Indyellen)\
**Post date:** [July 29, 2015, 5:06pm UTC](https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295/44 "2015-07-29T17:06:05Z")

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> [@ITR\_champion](#):
>
> Interested parties may want to check out _[The Illustrated Guide to ICD 10](http://www.icd10illustrated.com/)_

Thanks for sharing this! They also publish a similar book about Meaningful Use, which has been almost as much of a bane of my existence as ICD10. (I work for an EMR software company.)

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**Author:** ![bump](https://avatars.discourse-cdn.com/v4/letter/b/7c8e57/32.png) [@bump](https://boards.straightdope.com/u/bump)\
**Post date:** [July 29, 2015, 8:06pm UTC](https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295/45 "2015-07-29T20:06:55Z")

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Here’s one I used for a test case (Rhaegar Targaryen was the patient…)

Y37.450A- Military operations involving combat using blunt or piercing object, military personnel, initial encounter

A lot of these are circumstance codes, not actual diagnoses. For example, this was the circumstance, but you’d have to find some kind of ICD-10 code for crushed sternum or whatever actually would have put Rhaegar in the ER after the Trident.

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**Author:** ![GrumpyBunny](https://avatars.discourse-cdn.com/v4/letter/g/bc8723/32.png) [@GrumpyBunny](https://boards.straightdope.com/u/GrumpyBunny)\
**Post date:** [July 30, 2015, 3:05am UTC](https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295/46 "2015-07-30T03:05:00Z")

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> [@Shagnasty](#):
>
> I can’t express confidence in this new system at all. As far as I can tell, they cover most things for the first or second incidents but not for the subsequent ones. What about when my pet chinchilla bites me for the 5th or 6th time? Does that mean the tip of my fingernail cannot be restored by a specialist? My insurance would hopefully cover a really qualified Vietnamese manicurist because they are the best. I wouldn’t ever want to lose that option for healthcare service providers.

Try using the W53.81XS: Bitten by other rodent, sequela. (You’ll have to get the chinchilla breeders’ league to petition WHO for a more specific code.)

You can pay your $25 copay on the way out.

> [@ITR\_champion](#):
>
> I’m imagining ICD-10: The Game, where the player attempts to dodge falling alligators, attacking chickens, exploding wheelbarrows, and other such menaces.

Please develop this game! You’d have a lot of geeky coders playing that while drunk.

Well, _I_ can think of a dozen geeky people who’d play it, laughing manically the entire time.

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**Author:** ![Green\_Bean](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/green_bean/32/1760_2.png) [@Green\_Bean](https://boards.straightdope.com/u/Green_Bean)\
**Post date:** [July 30, 2015, 3:26am UTC](https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295/47 "2015-07-30T03:26:16Z")

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> [@Dr.Girlfriend](#):
>
> What about smelling of elderberries? That might fall under the personal hygiene code.

No, but they do have one for “Just a flesh wound.”

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**Author:** ![Fir\_na\_tine](https://avatars.discourse-cdn.com/v4/letter/f/a587f6/32.png) [@Fir\_na\_tine](https://boards.straightdope.com/u/Fir_na_tine)\
**Post date:** [July 30, 2015, 8:56pm UTC](https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295/48 "2015-07-30T20:56:53Z")

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> [@Green\_Bean](#):
>
> No, but they do have one for “Just a flesh wound.”

Errors in billing will cause the insurance carrier to fart in your general direction.

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**Author:** ![MmeRose](https://avatars.discourse-cdn.com/v4/letter/m/ee7513/32.png) [@MmeRose](https://boards.straightdope.com/u/MmeRose)\
**Post date:** [August 1, 2015, 11:38am UTC](https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295/49 "2015-08-01T11:38:04Z")

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> [@ITR\_champion](#):
>
> If you need more, I started [a thread on this topic in January.](http://boards.straightdope.com/sdmb/showthread.php?t=747949) My personal favorite:
> 
> If you have “acquired absence of right hand”, you’d need code Z89.111, while “acquired absence of left hand” is code Z89.112. And if you can’t tell which hand you’ve acquired an absence of, don’t worry: there’s a code for that too (Z89.119)
> 
> There are lists of symptoms for all these conditions as well.
> 
> Interested parties may want to check out _[The Illustrated Guide to ICD 10](http://www.icd10illustrated.com/)_

I’m sorry, all. I thought I had searched for it but obviously not well enough.

The movie and game are excellent ideas. Being of a melancholic turn of mind, I was thinking of a tragic novel or poem. You ideas are much better.

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**Author:** ![robert\_columbia](https://avatars.discourse-cdn.com/v4/letter/r/e79b87/32.png) [@robert\_columbia](https://boards.straightdope.com/u/robert_columbia)\
**Post date:** [August 1, 2015, 1:28pm UTC](https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295/50 "2015-08-01T13:28:28Z")

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> [@ITR\_champion](#):
>
> I’m imagining ICD-10: The Game, where the player attempts to dodge falling alligators, attacking chickens, exploding wheelbarrows, and other such menaces.

“Your water skis caught on fire. Miss a turn.”  
“Your behavior is strange and inexplicable. Proceed to swimming-pool of prison.”  
“Choose a player. That player is sucked into a jet engine and must roll a D20 to calculate damage and a D6 for cost of treatment.”  
“You are suffering from the toxic effect of tobacco cigarettes, intentional self-harm after having smoked a pack a day for thirty years. Roll a D6 to find out what kind of cancer you have.”  
“You find an agricultural transport vehicle in stationary use in the middle of a field. Draw an Incident card to find out what happens.”  
“You complained about an unspecified problem related to medical facilities and other health care and are now subject to social exclusion & rejection. Pay 500 coins to a reputation improvement specialist.”

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**Author:** ![robert\_columbia](https://avatars.discourse-cdn.com/v4/letter/r/e79b87/32.png) [@robert\_columbia](https://boards.straightdope.com/u/robert_columbia)\
**Post date:** [August 1, 2015, 1:35pm UTC](https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295/51 "2015-08-01T13:35:41Z")

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> [@ITR\_champion](#):
>
> I’m imagining ICD-10: The Game, where the player attempts to dodge falling alligators, attacking chickens, exploding wheelbarrows, and other such menaces.

“You walked into a lamppost while ruminating over problems in your relationship with your in-laws. Draw a Billing card.”

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**Author:** ![Sunspace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sunspace/32/1250_2.png) [@Sunspace](https://boards.straightdope.com/u/Sunspace)\
**Post date:** [August 2, 2015, 7:10pm UTC](https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295/52 "2015-08-02T19:10:09Z")

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That would be a great game. We could extend the classification as well, to involve fantasy incidents. Maybe they could be listed under Greek letters or something:

Σ23.43Z: Backblast from fire spell, sequelae.  
Δ1.655F: Accidentally turned into toad, first incident.  
Π3.141S: Improper circularization, first incident.

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**Author:** ![pbbth](https://avatars.discourse-cdn.com/v4/letter/p/f9ae1b/32.png) [@pbbth](https://boards.straightdope.com/u/pbbth)\
**Post date:** [August 3, 2015, 12:55am UTC](https://boards.straightdope.com/t/icd-10-a-new-endurance-test-for-doctors/726295/53 "2015-08-03T00:55:37Z")

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> [@psychobunny](#):
>
> Personally, I am glad to see that you can now code for left knee pain separately from right knee pain and that the fact that there was one code for all brain tumors and multiple codes for breast cancers depending on the exact location of the tumor has been somewhat rectified.

> [@MsRobyn](#):
>
> When I was a radiology coder, we had to be very careful with coding because half the time, the patient’s insurance company would reject a claim for third-party billing information, which is fine when the patient has sprained an ankle or broken an arm, but sucks ass when the patient is a 80-year-old wheelchair-bound grandmother with arthritis. Reimbursement for plain-film X-rays is bad enough, but the insurance company makes you _work_ for it.

I am so looking forward to ICD-10 because of this very issue. I spend a good 3 hours out of every day talking to billing providers who had claims denied, despite using appropriate modifiers, because our prehistoric computer system keeps seeing the same code billed twice and flagging it as a potential duplicate and requiring medical notes be submitted for review or other simple problems that shouldn’t require assistance. If ICD-10 will allow you to bill something down to such a specific level that it will no longer trigger a duplicate denial for left vs right knee surgery or for physical therapy that is coded specifically as not related to an accident so they don’t force you to try and coordinate benefits unnecessarily I will do a dance of glee right there in my cubical.

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