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Medical Billing Codes For Injury Via Turtle Among Thousands Created by New Law

A new government law has created an unusually precise list of injury codes for billing purposes. Currently there are 18,000 standard billing codes; the new law would expand that list to around 140,000. If you've been injured at the Opera, walked into a lamppost, pulled something while playing a trumpet, or have been attacked by a turtle, there's now a code for that. From the article: "The federal agencies that developed the system—generally known as ICD-10, for International Classification of Diseases, 10th Revision—say the codes will provide a more exact and up-to-date accounting of diagnoses and hospital inpatient procedures, which could improve payment strategies and care guidelines. "It's for accuracy of data and quality of care," says Pat Brooks, senior technical adviser at the Centers for Medicare and Medicaid Services."

380 comments

  1. Some turtle attack advice by elrous0 · · Score: 5, Funny

    The obvious temptation is to run, but that would be a mistake. NEVER show a turtle your fear.

    --
    SJW: Someone who has run out of real oppression, and has to fake it.
    1. Re:Some turtle attack advice by Anonymous Coward · · Score: 1

      These guys would have you believe differently.

    2. Re:Some turtle attack advice by brusk · · Score: 1

      Awww snap!

      --
      .sig withheld by request
    3. Re:Some turtle attack advice by Anonymous Coward · · Score: 0

      I've always managed to avoid turtle attacks by following some advice my sensei gave me.

      Walk softly and carry a large pepperoni pizza.

    4. Re:Some turtle attack advice by Anonymous Coward · · Score: 0

      Any code for injuries from robotic turtles? http://cyberneticzoo.com/?p=1711

    5. Re:Some turtle attack advice by Duradin · · Score: 1, Funny

      Do not poke snapping turtle with remaining fingers.

    6. Re:Some turtle attack advice by Anonymous Coward · · Score: 0

      My grandfather tried to save a duck who was being dragged under water by a snapping turtle. He slid an oar under the duck and flipped it into his row boat - both turtle and duck were in the boat with grandpa - there was a potential for a turtle attack.

    7. Re:Some turtle attack advice by GameboyRMH · · Score: 2

      Am I the only one who was immediately reminded of the hospital's "front desk control panel" in Idiocracy?

      --
      "When information is power, privacy is freedom" - Jah-Wren Ryel
    8. Re:Some turtle attack advice by GameboyRMH · · Score: 2

      Yeah you know they're going to have to add more codes anyways. They're not thinking ahead. Let me contribute some more:

      Injured by industrial robot
      Injured by robotic pet
      Injured by sex robot
      Amputation due to portal failure
      Broken bones due to faulty fall impact absorbers
      Jetpack crash
      Flying car crash
      Electric rollerblade crash

      --
      "When information is power, privacy is freedom" - Jah-Wren Ryel
    9. Re:Some turtle attack advice by INT_QRK · · Score: 1

      Unless you're Duke, then you should always FEAR THE TURTLE!

    10. Re:Some turtle attack advice by jhoegl · · Score: 1

      Automatic tying shoelaces tied too tight.

    11. Re:Some turtle attack advice by SleazyRidr · · Score: 1

      Is there a code for when you trip over, trying to run away from a turtle?

    12. Re:Some turtle attack advice by wzinc · · Score: 1

      But, I like turtles; what can I do to improve human-turtle relations so codes like this are unnecessary?

    13. Re:Some turtle attack advice by Anonymous Coward · · Score: 0

      The obvious temptation is to run, but that would be a mistake. NEVER show a turtle your fear.

      This turtle walks into a police station and says "I've been mugged!".

      The policeman says "Sorry to hear that, sir, can you describe your assailants?"

      "Yes! They were snails!"

      "I see - how many?"

      " I don't know - it all happened so quickly."

    14. Re:Some turtle attack advice by Anonymous Coward · · Score: 0

      Injured by sex robot

      A single code is not going to cover all of the possible permutations and positions and injuries.

    15. Re:Some turtle attack advice by Anonymous Coward · · Score: 0

      Keep in mind some species of snapping turtles can strike half the size of the body away. Some snapping turtles are very large so that can be longer some some arm's lengths. Some turtles can take several fingers off in on go. A turtle attack, as strange as it sounds, can be very vicious.

    16. Re:Some turtle attack advice by tillerman35 · · Score: 1

      Comment of the day! You, Sir, have teh funnay.

    17. Re:Some turtle attack advice by Quila · · Score: 1

      Hand amputation due to sticking it in front of an opening stargate

      Too much data loaded into brain implant.

      Bad reaction to R-47 (let's see who can catch that reference)

    18. Re:Some turtle attack advice by Malties · · Score: 1

      There are few more code opportunites Duck attack Combined Duck/Turtle attack Falling overboard escaping a duck/turtle attack

    19. Re:Some turtle attack advice by Obfuscant · · Score: 1

      Is there a code for when you trip over, trying to run away from a turtle?

      Be more specific. Tripping over what? You must differentiate between tripping over a log, a bog, a dog, a cog, a frog, or a balrog. Or just tripping over your own two feet, which is the common failure mode in most slasher movies.

      Does anyone else think that this changes the odds of them getting the data entered correctly from 1 in 18,000 to 1 in 140,000?

    20. Re:Some turtle attack advice by Alsee · · Score: 1

      Purple button at top center...
      Warning: do not attempt to plug headphone jack into testicle.

      -

      --
      - - You can't take something off the Internet! That's like trying to take pee out of a swimming pool.
    21. Re:Some turtle attack advice by Snarfangel · · Score: 1

      Hey, it's what killed Aeschylus.

      That's what happens when you are bald. Eagles think your head is a handy rock to drop turtles on.

      --
      This tagline is copyrighted material. Please send $10 for an affordable replacement.
    22. Re:Some turtle attack advice by fahrbot-bot · · Score: 1

      The really disappointing thing here is there's no sub-code for the kind of turtle. Why can't people think these things through?

      --
      It must have been something you assimilated. . . .
    23. Re:Some turtle attack advice by JWSmythe · · Score: 1

      Well, since Torchwood's new season (and probably the end of the series) just ended, I'd say anyone would be category 1, which is likely "R99 - Ill-defined and unknown cause of mortality"

      I like the lamppost options. 3 of them. :)

      W2202XA - Walked into lamppost, initial encounter
      W2202XD - Walked into lamppost, subsequent encounter
      W2202XS - Walked into lamppost, sequela

      But, to answer your question,
      it doesn't appear to matter,
      if it were a cat or a hat,
      nor a clam or a ham.
      or a boat in a moat.
      It doesn't matter "Sam I Am"

      The important part, frm what I can see in the codes, is that you slipped, tripped, stumbled or fell, and the general category of what you impacted on.

      If you tripped, but didn't fall, it could be one of these.


      W1840XA - Slipping, tripping and stumbling without falling, unspecified, initial encounter
      W1840XD - Slipping, tripping and stumbling without falling, unspecified, subsequent encounter
      W1840XS - Slipping, tripping and stumbling without falling, unspecified, sequela
      W010XXA - Fall on same level from slipping, tripping and stumbling without subsequent striking against object, initial encounter
      W010XXD - Fall on same level from slipping, tripping and stumbling without subsequent striking against object, subsequent encounter
      W010XXS - Fall on same level from slipping, tripping and stumbling without subsequent striking against object, sequela

      Aw hell, I'll just post the tripping list instead.

      I'm not quite sure why the hell you'd have subsequent encounter with things like power tools. Most people would learn the first time.


      W010XXA - Fall on same level from slipping, tripping and stumbling without subsequent striking against object, initial encounter
      W010XXD - Fall on same level from slipping, tripping and stumbling without subsequent striking against object, subsequent encounter
      W010XXS - Fall on same level from slipping, tripping and stumbling without subsequent striking against object, sequela
      W0110XA - Fall on same level from slipping, tripping and stumbling with subsequent striking against unspecified object, initial encounter
      W0110XD - Fall on same level from slipping, tripping and stumbling with subsequent striking against unspecified object, subsequent encounter
      W0110XS - Fall on same level from slipping, tripping and stumbling with subsequent striking against unspecified object, sequela
      W01110A - Fall on same level from slipping, tripping and stumbling with subsequent striking against sharp glass, initial encounter
      W01110D - Fall on same level from slipping, tripping and stumbling with subsequent striking against sharp glass, subsequent encounter
      W01110S - Fall on same level from slipping, tripping and stumbling with subsequent striking against sharp glass, sequela
      W01111A - Fall on same level from slipping, tripping and stumbling with subsequent striking against power tool or machine, initial encounter
      W01111D - Fall on same level from slipping, tripping and stumbling with subsequent striking against power tool or machine, subsequent encounter
      W01111S - Fall on same level from slipping, tripping and stumbling with subsequent striking against power tool or machine, sequela
      W01118A - Fall on same level from slipping, tripping and stumbling with subsequent striking against other sharp object, initial encounter
      W01118D - Fall on same level from slipping, tripping and stumbling with subsequent striking against other sharp object, subsequent encounter
      W01118S - Fall on same level from slipping, tripping and stumbling with subsequent striking against other sharp object, sequela
      W01119A - Fall on same level from slipping, tripping and stumbling with subsequent striking against unspecified sharp object, initial encounter
      W01119D - Fall on same level from slipping, tripping and stumbling with subsequent striking against unspecified sharp object, subsequent encounter
      W01119S - Fall o

      --
      Serious? Seriousness is well above my pay grade.
    24. Re:Some turtle attack advice by Obfuscant · · Score: 1

      I'm not quite sure why the hell you'd have subsequent encounter with things like power tools. Most people would learn the first time.

      Well, a guy with a lost thumb and a broken toe would have "initial encounter" for cutting off his thumb with the circular saw, and "subsequent encounter" for dropping it on his foot when he grabbed his thumb to stop the bleeding.

      I suffer from T43616D (Underdosing of caffeine, subsequent encounter) every morning. A few dozen cups of coffee later, and I'm fine.

      Be careful, your insurance company may want to subrogate its costs by suing a decaf coffee company. Personally I suffer from "T408X6D - Underdosing of lysergide [LSD], subsequent encounter". I'm going to present that symptom at my next checkup just to see if I can get it resolved.

    25. Re:Some turtle attack advice by JWSmythe · · Score: 1

          Well, if there's an underdosing diagnosis, there must be a cure for it. :) I wonder what medical conditions they're prescribing it for these days. For teenagers, it seems to be a cure for boredom. For the rest of us, we're just "weird old people" if we drop acid.. Err, umm, partake of illicit drugs, that I swear I have no knowledge of. :)

          They don't seem to have a code for 3,4-Methylenedioxymethamphetamine (MDMA, Ecstasy), and amphetamine is just too vague. It would probably have a tie-in to Z7251 (High risk heterosexual behavior). :)

      --
      Serious? Seriousness is well above my pay grade.
    26. Re:Some turtle attack advice by Anonymous Coward · · Score: 0

      I don't know about that one but a friend of mine in med school showed me one of her class handouts in the class where they were going over x-ray procedures.

      It was an x-ray of a patient with a bottle stuck up what appeared to be her vaginal cavity.

      The thing that most of the class missed was the other thing they were supposed to notice in the picture that affected methods of treatment: the artificial hip.

    27. Re:Some turtle attack advice by cvtan · · Score: 1

      Old BMW motorcycle or Blackberry?

      --
      Sorry, but gray text on gray background is making my eyes bleed.
    28. Re:Some turtle attack advice by Quila · · Score: 1

      "The R Master" by Gordon R. Dickson.

    29. Re:Some turtle attack advice by HappyPsycho · · Score: 1

      I was wondering what code "W5921XD - bitten by turtle, subsequent encounter" was for...

    30. Re:Some turtle attack advice by Spugglefink · · Score: 1

      Yeah you know they're going to have to add more codes anyways. They're not thinking ahead. Let me contribute some more:

      Gang raped by naked women wearing Tux T-shirts is code WX894953T. That's some impressive list.

    31. Re:Some turtle attack advice by demonlapin · · Score: 1

      Injured by industrial robot

      I'm not at work, so I don't have access to an ICD code list, but I'm pretty sure this one is already in the ICD-9.

    32. Re:Some turtle attack advice by Anonymous Coward · · Score: 0

      You talk like a fag, and your shit's all retarded.

    33. Re:Some turtle attack advice by shortscruffydave · · Score: 1

      I'm not quite sure why the hell you'd have subsequent encounter with things like power tools. Most people would learn the first time.

      There was a case a few years ago, quite local to me as it happens, of a farm worker who lost his arm in a piece of machinery. There then followed a site inspection by the health & safety people, and the same guy accidentally severed his other arm while demonstrating how the initial accident had happened.

    34. Re:Some turtle attack advice by NiteShaed · · Score: 1

      Well 'e won't be bothering anyone anymore. 'e's completely 'armless now, innit?

      --
      Some bring out the best in others, some the worst. Some bring out far more.
    35. Re:Some turtle attack advice by NiteShaed · · Score: 1

      naked women wearing Tux T-shirts

      say what now?

      --
      Some bring out the best in others, some the worst. Some bring out far more.
  2. Good for insurance by Spunkee · · Score: 2, Insightful

    This is designed to make it easier for insurance companies to deny payment in more situations. The overhead created will increase costs for everyone and that's good for the people at the top.

    Hopefully the system implodes on itself.

    1. Re:Good for insurance by royallthefourth · · Score: 1

      This is designed to make it easier for insurance companies to deny payment in more situations. The overhead created will increase costs for everyone and that's good for the people at the top.

      Hopefully the system implodes on itself.

      We can't wait around for it to implode. If this occurs, there will be no healthcare at all for a while until a new system is created. What needs to be done is to create the new system now so that we have a much shorter window of pain.

      Also, there's no evidence that it will hit some critical value where its internal contradictions would be the sole force to cause it to implode. More likely it'll just get worse and worse until it hits a point where it is pushed to collapse from the outside, facilitated by its internal weakness. We already know it to be illegitimate; it will likely prove weak as well if faced with serious opposition. It's more a question of how long we, the outside, are willing to wait to knock it over. Hoping won't accomplish anything.

    2. Re:Good for insurance by Anonymous Coward · · Score: 2, Insightful

      Other than plain old tin-foil hat paranoia and idiotic 'the only reason anyone does anything is to fuck me' thinking, what exactly do you base this on? And what idiot marked it 'informative'? Where is the information? Are the rantings of every loony now considered 'information'?

    3. Re:Good for insurance by Marillion · · Score: 1

      Furthermore, it may lead to patients lying to their physicians. When you have codes that suggest "hazardous" activities, if patients worry about rise in premiums due to risky behavior then they may lie about the cause of an injury. Patient: "I broke my arm bone while going to church." Doctor: "You wear skateboard pads to church?" Patient: "Um ... sure, doesn't everyone?"

      --
      This is a boring sig
    4. Re:Good for insurance by royallthefourth · · Score: 2

      Doctor: "You wear skateboard pads to church?"

      Those damn evangelicals are always trying new gimmicks to increase attendance. Xtreme 4 Jesus &c.

    5. Re:Good for insurance by Anonymous Coward · · Score: 0

      Wow, for an anonymous coward, you are connected to some pretty good sources who seem to tell you all these massive projects the government is undertaking that nobody else has heard about. Congrats!

    6. Re:Good for insurance by Attila+Dimedici · · Score: 0

      No, it is designed to make it easier for Medicare and Medicaid to deny payment and to allege fraud, any benefit to the insurance companies is purely ancillary.

      --
      The truth is that all men having power ought to be mistrusted. James Madison
    7. Re:Good for insurance by jahudabudy · · Score: 1

      People already lie to their physician all the time; I doubt this will have a significant impact on that. And if it does, so what? You think the doctor is going to treat an arm broken at church differently than an arm broken skateboarding?

      --
      ...sometimes, in order to hurt someone very badly, you have to tell that person terrible lies. - PA
    8. Re:Good for insurance by vmaldia · · Score: 1

      This is designed to make it easier for insurance companies to deny payment in more situations. The overhead created will increase costs for everyone and that's good for the people at the top.

      Hopefully the system implodes on itself.

      i used to work with ICD-10 and from my experience I believe that it was indeed made by and for insurance companies. A system made for and by doctors and patients would make things EASIER instead of more time consuming and complicated

    9. Re:Good for insurance by jahudabudy · · Score: 1

      Considering that insurance billing currently has nothing to do with injury coding, and this is merely the next iteration of it, I think your paranoia is misplaced.

      --
      ...sometimes, in order to hurt someone very badly, you have to tell that person terrible lies. - PA
    10. Re:Good for insurance by limbodog · · Score: 5, Informative

      The 25 or so other countries who use these codes already have not yet imploded.

    11. Re:Good for insurance by gandhi_2 · · Score: 1

      You don't think the insurance company is going to treat an arm broken at church differently than an arm broken skateboarding?

      The government being the insurance company only means they now will have machineguns.

    12. Re:Good for insurance by avandesande · · Score: 3, Insightful

      Statements like this make it clear that people don't understand the nature of the insurance industry.
      They don't want to deny anything, as long as the other companies are forced to cover the same issue. That's why they want everything classified, so there is parity of coverage.
      I know it sounds counter intuitive but insurance companies make their money by skimming a percentage off of every transaction. That's why lobbyists pushed through the HMO model, which gave them a 'vig' from small transactions that people could just pay for out of pocket. The higher healthcare costs are, the more money they make.

      The important thing is that other insurers are forced to cover everything so they won't have an advantage by being able to deny things. Insurance companies want costs to be high so they can justify their exorbitant fees.

      --
      love is just extroverted narcissism
    13. Re:Good for insurance by Anonymous Coward · · Score: 0

      "there will be no healthcare at all for a while until a new system is created"

      There will be healthcare, but you will just have to PAY for it yourself rather than forcing your neighbor to pay for it through taxes and higher permiums. Doctors will not vanish if our socilized medical system disappears.

    14. Re:Good for insurance by royallthefourth · · Score: 1

      I'm not really talking about the codes in the article but about the almost completely broken insurance-health complex in the United States. Maybe you meant to address someone else...?

    15. Re:Good for insurance by Corf · · Score: 1
      --
      The pain was excruciating and the scarring is likely permanent, but that just means it's working.
    16. Re:Good for insurance by jahudabudy · · Score: 1

      Neither the government (Medicaid, Medicare) nor private insurance companies currently base payment on injury codes, so I'm not sure why you think they will begin to now.

      --
      ...sometimes, in order to hurt someone very badly, you have to tell that person terrible lies. - PA
    17. Re:Good for insurance by LifesABeach · · Score: 1

      Think about it, "who will be impacted by increasing by an order of magnitude of ways folks are Diagnosed?" The short answer is Medical Biller's for Medicare, and Medicaid. Biller's typically get 8% to 5% of the gross; it looks like they'll be staying up late working on their "billing skills". And not to be ignored are the various tasks doctors need to do given the diagnoses, they bill for that also. The other group of people are the ones who write Medical Billing Software. For us software types, that means someone will have to insert the codes into the data base, then test. I'd figure this looks to be like a 2 to 3 day task for the junior programmer over there in the corner; or a 4 hour task for the senior staff. What I find interesting will be the various tasks doctors will get to bill for. A lot will be the same, but the exceptions will be so vast that only WATSON could sift through it in any reasonable amount of time. I wonder if IBM has any openings for support to maintain WATSON?

    18. Re:Good for insurance by gandhi_2 · · Score: 1

      I'm sure there will be a rush to file injuries incurred while using "burning water-skis".

      WTF?

      http://graphicsweb.wsj.com/documents/MEDICALCODES0911/#term=Water-skis

    19. Re:Good for insurance by SleazyRidr · · Score: 3, Funny

      This isn't Twitter, there's plenty of room to post the full URL here. Unless you're just trying to hide a Goatse link...

    20. Re:Good for insurance by chiguy · · Score: 0

      The 25 or so other countries who use these codes already have not yet imploded.

      When doctors are salaried and are paid for the extra time they spend pushing papers, as they are in other western countries, then it's no big deal. The government-paid doctors just see fewer patients and make the same amount of money.

      In the US, however, this is an unfunded mandate. Doctors spend an extra few minutes looking up more detailed codes per patient, times the number of doctors, and you can see the economic impact.

      --
      passetspike!
    21. Re:Good for insurance by Anonymous Coward · · Score: 0

      At least they have "Struck by football". Finally, Hans can get the treatment he needs.

      http://graphicsweb.wsj.com/documents/MEDICALCODES0911/#term=football

    22. Re:Good for insurance by aztektum · · Score: 1

      Now they have to implement new computer systems to add 122k new codes, costing the healthcare providers money, pushing costs up, helping the insurance industry skim more?

      --
      :: aztek ::
      No sig for you!!
    23. Re:Good for insurance by Anonymous Coward · · Score: 0

      Statements like this make it clear that people don't understand the nature of the insurance industry.
      They don't want to deny anything, as long as the other companies are forced to cover the same issue. That's why they want everything classified, so there is parity of coverage.
      I know it sounds counter intuitive but insurance companies make their money by skimming a percentage off of every transaction. That's why lobbyists pushed through the HMO model, which gave them a 'vig' from small transactions that people could just pay for out of pocket. The higher healthcare costs are, the more money they make.

      The important thing is that other insurers are forced to cover everything so they won't have an advantage by being able to deny things. Insurance companies want costs to be high so they can justify their exorbitant fees.

      Two questions:
      What you're saying is the exorbitant fees don't increase when they keep collecting but are allowed to deny claims?
      Ever work as a PR person for an insurance company?

    24. Re:Good for insurance by chiguy · · Score: 2

      Neither the government (Medicaid, Medicare) nor private insurance companies currently base payment on injury codes, so I'm not sure why you think they will begin to now.

      Because the current ICD-9 codes do not have detailed causation. Here's what a billing looks like:

      Fracture of lower limb (820–829)

              (820) Fracture of neck of femur
              (821) Fracture of other and unspecified parts of femur
              (822) Fracture of patella
              (823) Fracture of tibia and fibula
              (824) Fracture of ankle
              (825) Fracture of one or more tarsal and metatarsal bones
              (826) Fracture of one or more phalanges of foot
              (827) Other, multiple, and ill-defined fractures of lower limb
              (828) Multiple fractures involving both lower limbs, lower with upper limb, and lower limb(s) with rib(s) and sternum
              (829) Fracture of unspecified bones

      The injury is indicated. The cause is not.

      But if you give insurance companies more information about the circumstances of injury, as you do in ICD-10, then you allow insurance companies the information to more finely deny coverage. So your insurance policies now state they will cover injuries except for those that occur on a list of dangerous activities.

      And in case you think they wouldn't micromanage like that, a friend of mine was able to get insurance coverage but ANY injury to his left knee, which had an ACL repair done 20 years ago, would not be covered.

      In an era where both public and private insurance is trying to save money, more reasons to deny coverage is sure to come out of this.

      --
      passetspike!
    25. Re:Good for insurance by Anonymous Coward · · Score: 0

      "I know it sounds counter intuitive but insurance companies make their money by skimming a percentage off of every transaction."

      It sounds counter intuitive because it is wrong.

      The private health insurance business model (simplified) is:
      1. Collect monthly fees from subscribers. This is the income.
      2. Expenses are claims paid plus overhead (labor costs, utilities, lobbying, etc.)
      3. Income (subscriber fees) minus expenses (claims and overhead) = profits.

      Insurers do not earn "a percentage off of every transaction," if they did you would see them advertising non stop to promote subscribers use of medical services and drugs that would generate claims. They dont do this because it would cut away at their profit. Instead they advertise basic health advice, like eat healthy/watch your weight, get regular exercise, call the insurance company nurse for medical advice rather than go to the ER, etc., activities likely to reduce medical services used that would eat away at profit.

    26. Re:Good for insurance by Unkyjar · · Score: 1

      Insurance billing has a lot to do with injury coding. Often the only way to get an insurance company to pay on a claim is to resubmit under an alternate ICD-9 code.

    27. Re:Good for insurance by chiguy · · Score: 1

      Considering that insurance billing currently has nothing to do with injury coding, and this is merely the next iteration of it, I think your paranoia is misplaced.

      WTF?

      CMS1500 billing forms require you specify both an ICD-9 diagnosis code (that would be the "injury code" you're denying) and a CPT procedure code (that would be what you did for the injury you coded).

      So you're obviously pulling s* out of your a*

      --
      passetspike!
    28. Re:Good for insurance by Jawnn · · Score: 1

      How right you are. I work for an enterprise that, in some of it's business units, bills medical insurance companies for goods and services. Five minutes of observation will make it abundantly clear that the insurers are doing their level best to make it hard for vendors to collect on behalf of the insured. And people wonder why medical care costs so much.

    29. Re:Good for insurance by jahudabudy · · Score: 2

      ICD-9 DOES have detailed causation, although not nearly as detailed as ICD-10, it looks like. ICD-9 has "Coded Cause of Injury Codes", AKA "E Codes" (they all start with E). These are distinct from the Injury Diagnosis Codes, which you provided examples of above. For instance -> E029.2 - Rough Housing and Horseplay. Or E885.4 - Accidental fall from Snowboard. These seem to fit your criteria of plausibly deniable causes of injury, are currently available, yet aren't being used by insurance companies.

      --
      ...sometimes, in order to hurt someone very badly, you have to tell that person terrible lies. - PA
    30. Re:Good for insurance by jahudabudy · · Score: 1

      Simmer down, big boy. ICD-9 diagnosis codes are just that, diagnosis codes. Completely distinct from ICD-9 Coded Cause of Injury codes. They have distinct value ranges and different labels in the DG1 segment of HL7 and everything.

      Just b/c you don't know what you're talking about doesn't mean those of us that do are just making it up.

      --
      ...sometimes, in order to hurt someone very badly, you have to tell that person terrible lies. - PA
    31. Re:Good for insurance by Unkyjar · · Score: 2

      Actually, this completely incorrect. Aetna, Blue Cross Blue Shield, Cigna, Humana, United Healthcare, and Unicare all base denials around injury codes.

    32. Re:Good for insurance by jahudabudy · · Score: 1

      How? Maybe it differs from state to state, but in NC, the E code isn't a required field on claims forms. Most of the hospital billing systems I am familiar don't even store these - they are only stored in the clinical systems. They certainly aren't included on any claims forms. I'll admit, I'm only familiar with hospital systems, so maybe ambulatory care is different.

      --
      ...sometimes, in order to hurt someone very badly, you have to tell that person terrible lies. - PA
    33. Re:Good for insurance by chiguy · · Score: 1

      Woah mods. Mod him up. This guy is absolutely right. GP doesn't know what he's talking about.

      --
      passetspike!
    34. Re:Good for insurance by jahudabudy · · Score: 1

      In this context, ICD-9 is generally used to mean injury diagnosis code (what is wrong), not coded cause of injury (how it happened). Both are part of the ICD-9 spec, but completely distinct inside that spec. If the code value starts with an E, it's coded cause of injury. If it is a value from 800-999, it's an injury diagnosis code.

      --
      ...sometimes, in order to hurt someone very badly, you have to tell that person terrible lies. - PA
    35. Re:Good for insurance by Anonymous Coward · · Score: 0

      you obviously don't work on the getting-doctors-paid side of the business. They often force you to use their antiquated phone systems as the only way to get answers, instead of email/websites, and when they do put info on their website, it's buried so deep that it's impossible to Google. They will deny a claim and put on the denial that you must call them, instead of just putting the reason code on the EOB (as required, btw). then you wait on the phone for an hour, or get bounced around to different departments, or talk to incompetents.

      It's a very effective maze so that people give up trying to get answers and get the claims reprocessed and instead just write off the denial as a loss.

    36. Re:Good for insurance by OldeTimeGeek · · Score: 3

      In my experience, doctors don't look up anything. They write down what they did or what is needed for a referral and leave it up to their secretaries/receptionists to figure how to map it to the codes that the insurance companies use.

    37. Re:Good for insurance by Unkyjar · · Score: 1

      Private insurance policies in New York and Texas will deny based on the ICD-9 billed. This is usually due to specific limitations and exclusions in the policy. Speech Therapy, Occupational Therapy, Physical Therapy all have this problem. For instance for Speech Therapy many Aetna policies will deny 315.32 (mixed expressive receptive language disorder) or 307.0 (stuttering) because it isn't an acceptable ICD-9 under their updated policies (which mainly, state that Speech Therapy is covered but only in the case of accident, injury or gross anatomical birth defect) but have no problem paying 784.59 (Other Speech Disturbance). Choosing the correct ICD-9 code out of the various diagnosis the therapist gives you, as well as knowing which one to bill primary or to not include so that a patient can receive covered care is very important in a clinical office setting. Though this is always done with the assent of the Therapist to make sure the diagnosis does apply to the patient.

    38. Re:Good for insurance by Tony+Isaac · · Score: 1

      As a software developer in the medical insurance industry, I see a couple of problems with your argument.

      First, if insurance companies can find a reason to deny a claim, they will. Try going to one of the new free-standing ER clinics, many of which do not have contracts with insurance companies, and see how many hoops you have to jump through to get insurance to pay.

      Second, insurance companies do not make money by taking a percentage of transactions. Their income comes from premiums, withheld from your paycheck each month. Their profit is the amount left over when you subtract claim payments and administrative overhead from the total income from policy premiums.

    39. Re:Good for insurance by chiguy · · Score: 1

      Statements like this make it clear that people don't understand the nature of the insurance industry.

      No, health insurance is just like any other insurance, such as car insurance.

      1) Insurers collect premiums. This is their revenue.
      2) Insurers spend money on running their business. This is overhead.
      3) Insurers pay out money for covered events. This is claims paid.
      4) What's left over is profit.

      Every transaction (claim) costs insurers money. Be it healthcare, auto, or life.

      This poster does not understand the nature of any insurance industry, much less American health insurance.
      If they can deny a claim, then they can keep the money that they collected through premiums as profit.

      I know it sounds counter intuitive but insurance companies make their money by skimming a percentage off of every transaction

      It's counter-intuitive because it's not true.

      Having been in healthcare for a while now, I have no idea what this poster is talking about.

      --
      passetspike!
    40. Re:Good for insurance by Unkyjar · · Score: 1

      You were unclear in your statement, and not specific that you were speaking of the cause of injury. I think most people reading your statement would interpret it as I did, that you were indicating that ICD codes have nothing to do with insurance billing.

      Also when looking at worker's compensation and no-fault claims you'll find that cause of injury is often given great scrutiny by the adjuster when deciding upon whether to pay outright or to force a hearing.

    41. Re:Good for insurance by jahudabudy · · Score: 1

      Ok, I think that applies everywhere (the general rule, not necessarily your specific examples). Insurance companies have byzantine policies. What you are listing are ICD-9 diagnosis codes, however. I'm referring to the ICD-9 Coded Cause of Injury (E codes). These are the codes that tell HOW an injury occurred, not WHAT the injury was. And of course, only apply to classified injuries, not diseases or disorders such as you list. I think that is why so many people are confused here - E codes are actually pretty damn rare, and mostly only of interest to Injury Prevention folks. Many healthcare providers don't bother with them, specifically because they have no impact on billing.

      --
      ...sometimes, in order to hurt someone very badly, you have to tell that person terrible lies. - PA
    42. Re:Good for insurance by Bucky24 · · Score: 1

      If the system was designed properly in the first place it should be scaleable....
      Then again this is medical software we're talking about.

      --
      All the world's a CPU, and all the men and women merely AI agents
    43. Re:Good for insurance by Unkyjar · · Score: 1

      As I stated in another reply to you, I noted that you were not clear in your initials sweeping statements, and so I wanted to be very clear to anyone reading the thread that ICD-9/ICD-10 codes and billing/payment are very much reliant upon each other. Also that with Worker's Compensation claims (and sometimes no-fault) the E codes are often required by specific companies.

    44. Re:Good for insurance by jahudabudy · · Score: 1

      This entire thread, and in fact article, revolves around the concept of expanding the cause of injury codes. I was responding to a comment that it is a plot by insurance companies to begin collecting these codes in order to have greater leeway to deny coverage. It's all about context. Speaking of which, I imagine you're right that worker's comp and no-fault claims closely scrutinize cause of injury (I hadn't thought of these cases). But can anyone seriously argue that is an abuse?

      --
      ...sometimes, in order to hurt someone very badly, you have to tell that person terrible lies. - PA
    45. Re:Good for insurance by bk2204 · · Score: 2

      Actually, the ICD-10 is created by the World Health Organization. The goal is to have a code for pretty much any medical-related concept not to increase overhead but to have a language-independent way of discussing and improving health. Determining the existence and spreading of public health issues is a lot easier when you can simply search medical records with a code.

    46. Re:Good for insurance by Unkyjar · · Score: 1

      It sounds to me like you're suggesting that insurance companies which are already denying claims based on underlying cause of injury (birth defect is covered but development isn't) won't adapt their policies to be more specific in which ICD-10's are denied with changeover.
      In my opinion they will abuse the system as best they can, and we'll try to figure out ways around their loopholes and exceptions, but I don't doubt it'll be harder under the new coding system.

    47. Re:Good for insurance by Marillion · · Score: 1

      No, not in the case of breaking an arm. It was merely the first injury that popped into my head. I wasn't suggesting to take that literally, but rather trying to suggest any number of plausible scenarios where a patient deliberately deceives a physician out of fear of insurance company reactions. The "Chilling Effect" as it were. And it's plausible that there is a scenario where that lie could jeopardize the quality of care.

      --
      This is a boring sig
    48. Re:Good for insurance by Anonymous Coward · · Score: 0

      Uhm, yeah, it doesn't help that the hospitals are raping them with exorbitant fees -- 40 bucks for Tylenol. o_O
      I knew about this, so I brought my OWN, and they CHARGED me for ME dosing MYSELF.

      Of course I complained, but unless you get the full prescribed treatment the insurance won't cover your stay -- It's a Catch 22 -- apparently code W5609XA requires two days of medical supervision before they allow you to say, "So long, and thanks for all the fish."

    49. Re:Good for insurance by jahudabudy · · Score: 1

      It's possible, I suppose. However, the scenario we are discussing is the narrow one where it is an actual traumatic injury, with an external cause. These are generally fractures, lacerations, burns, swelling, poisoning, traumatic injuries. About the only one I could see being a concern would be something like an illegal drug overdose. The doctor would certainly base treatment on the exact nature of the poisoning. But people already lie about those sorts of things, nothing to do with insurance concerns. I really can't imagine any other injuries where exactly how the injury occurred would affect treatment of the injury itself.

      --
      ...sometimes, in order to hurt someone very badly, you have to tell that person terrible lies. - PA
    50. Re:Good for insurance by avandesande · · Score: 1

      Sure you are taking an accountants view and are correct that the insurance company will exploit every loophole to deny creating profit in the short term. However, in the long run they want to close loopholes to drive up costs. Does the insurance company want 10% of a 10,000$ account or 10% of a 20,000$ account?
      Now for the car analogy-
      US auto manufacturers are always lobbying for new safety standards. Most consumers would not be interested in buying the safety widget, but if they are forced to the auto manufacturer gets another component they can 'skim' off of.

      When regulation and governance is involved inefficiency creates profit opportunities.

      --
      love is just extroverted narcissism
    51. Re:Good for insurance by avandesande · · Score: 1

      Short term you are correct. Long term their goal is to close the loopholes and drive up costs. I have a more lengthy explanation in another part of the thread.

      --
      love is just extroverted narcissism
    52. Re:Good for insurance by Bob+the+Super+Hamste · · Score: 1

      I take it you have never been to a Catholic mass before. They are always knelling so I wouldn't blame some one for wanting to wear some knee pads.

      --
      Time to offend someone
    53. Re:Good for insurance by skids · · Score: 1

      Maybe the "medical loss ratio" provisions in ACA? Of course one would have to assume rising premiums as well, but that seems to be a forgone conclusion.

    54. Re:Good for insurance by sjames · · Score: 1

      Have they set up a similar initiative to allow mere mortals who are already overworked and underpaid to actually know which code to apply? Some sort of near AI search mechanism where a description goes in and the correct codes come out?

      Just how much call is there for NINE turtle related injury codes? Surely W5922Xa Struck by a turtle could be covered under a more general code for struck by an object (unless they thing TMNT are real).

      The point is, someone has to actually enter this drivel into a database. Medical billing complexity has already gotten out of hand without 140,000 codes.

      This all stinks strongly of some bureaucrat who found that he had no workload and figured he'd better do something to look busy.

    55. Re:Good for insurance by itsenrique · · Score: 1

      Parent is in the know.

    56. Re:Good for insurance by JoeMerchant · · Score: 1

      ICD-9 billing specialists are already "highly trained, skilled information workers," this just means that ICD-10 will create a higher bar to entry and a more elite and well paid position converting M.D. scribble to auditable, reimbursable coding.

      Notice the complete lack of connection to reality in all of the above...

    57. Re:Good for insurance by Chitlenz · · Score: 1

      So much this! I'm no big fan of insurance companies, but they only care about what procedure(s) are performed and what materials were used. Observations (ie - A patient note of a "cough" when seeing a patient for med refills) end up getting wrapped up into ANONYMOUS reports, which consequently go back to places like CDC. From this, hopefully one day, we can start to track trends of things like Bird Flu before they become widespread epidemics. Right now, specifically because of consumer paranoia about privacy and insurance, there can be a lot of lag time in reporting social problems which may, in fact, affect us all. Just food for thought there.

      --
      Imagination is the silver lining of Intelligence.
    58. Re:Good for insurance by Chitlenz · · Score: 1

      Say WHAT?!?!? I don't know ANY doctors who don't have at least a CPT reference to work from. Most have one of the plethora of iphone apps for coding lookup for sale if they don't have up to date EMR software (see CCHIT certification for more about what that is). What we do is try to make interfaces that allow a doctor to type in "turtle" (nod to top level author) to get filtered list of possibilities, rather than having to memorize codes. Coding is really an antique process, so as programmers its our job to make it a plain english experience for doctors. What you are missing is that billing codes and diagnostic codes are two interrelated things though, and that the bill (while important) is really only a part of the picture. A good for instance is people with drug allergies. A good EMR system has to cross reference any pending Rx requests to make sure that something you (as a patient) are given doesn't not have an allergic affect on you. This has nothing to do with billing, but everything to do with health, and should happen in realtime, not at the front desk. To me, a good programmer sees automation of complex processes like this as opportunity (and indeed, it can be a very lucrative one, even in these trying times) instead of something to be ignored and borne. In fact... who's your doctor again? J/K :D

      --
      Imagination is the silver lining of Intelligence.
    59. Re:Good for insurance by Anonymous Coward · · Score: 0

      How many of those countries have "socialized healthcare"?

    60. Re:Good for insurance by Carnildo · · Score: 1

      Water skis are treated as a type of boat, so they get all the standard code variations for boat-caused injuries. Compare the water-ski list to the beginning of http://graphicsweb.wsj.com/documents/MEDICALCODES0911/#term=fishing_boat

      --
      "They redundantly repeated themselves over and over again incessantly without end ad infinitum" -- ibid.
    61. Re:Good for insurance by Anonymous Coward · · Score: 0

      It goes without saying that an actual NEW disease spreading across the world won't have an assigned code yet, and the population will be dead before a code can be assigned, distributed, and medical software updated to accept it.

    62. Re:Good for insurance by CCarrot · · Score: 1

      The 25 or so other countries who use these codes already have not yet imploded.

      Yeah, but lots of those countries have much bigger turtles...

      --
      "I love animals! Some are cute, others are tasty, what's not to like?" - Betsy Schroeder, Jeopardy contestant
    63. Re:Good for insurance by Kalriath · · Score: 1

      For us, it's just a matter of populating a couple of DB tables and expiring the old coding system. Then again, being outside the US we did that 10 years ago.

      --
      For a site about things like basic rights, Slashdot users sure do like to censor "dissent".
    64. Re:Good for insurance by Moryath · · Score: 1

      And this is why Obamacare was actually a GOOD thing, because it makes "preexisting condition" blockage like that ILLEGAL.

    65. Re:Good for insurance by bws111 · · Score: 1

      Actually, if you think about it, they are doing the exact opposite of what you say. No-one is entering nine codes for turtle-related injuries anywhere. Instead, they create a category like 'Animal'. There are three codes for injuries caused by animals - bitten, struck by, and other. Then they list the animals, turtle being one of them. In addition to that, there are the three general codes for the doctor visit - initial, followup (subsequent), and chronic (sequela). Then, this amazing thing called a 'computer' magically combines the three 'animal' injuries (for animal == turtle) with the three visit codes, and magically you have nine codes.

      As for knowing what code to apply - how difficult can it be to have a menu system that contains Animal->Turtle->Bite? Any decent piece of software could easily have another field (maybe a radio button or something) for the three visit reasons.

      Why do they need to know that a turtle was involved? Well, different animals carry different diseases, don't they? This information is not used only for insurance purposes, it also goes to places like the CDC.

    66. Re:Good for insurance by demonlapin · · Score: 1

      Don't forget that there is another realm - the hospital - in which the doctor finds all sorts of notes from the hospital's coders who are trying to find some more ICD's in order to upgrade to a better-paying DRG.

      Doctors who don't pay at least some attention to coding are doctors who don't depend on 992xx for their income.

    67. Re:Good for insurance by russotto · · Score: 1

      I know it sounds counter intuitive but insurance companies make their money by skimming a percentage off of every transaction.

      It's true that there's money in taking premiums and paying claims. It's also true that there's a lot MORE money to be had by taking premiums and NOT paying claims.

    68. Re:Good for insurance by sjames · · Score: 1

      So, the patient is bitten by a tortoise. Is turtle close enough or should it be animal->other? As far as diseases, being struck by a turtle is extremely unlikely to be any different in any medically relevant way to being hit by any hard object.

      And just how many flaming water ski accidents happen in a year? Just how many spacecraft collisions result in a visit to the local hospital with an insurance billing event? As far as I know, there have only been a couple of spacecraft collisions at all and it's a good thing nobody was hurt because they wouldn't have made it back to Earth in time to go to the hospital. They might as well have a code for an accident involving a particle accelerator and a paper clip. Does exploding on ascent then splashing into the ocean count as crash or other? How about a breakup during reentry? As it turns out, those sorts of mishaps have never resulted in a hospitalization at all anyway, the crew tend to die in such events. It certainly makes the whole thing seem more tongue in cheek than serious, but somewhere there's a minor bureaucrat with a stick up his ass (I have no idea what the code is for that) who will gum up the whole works if, God forbid, someone enters the wrong code.

      If an airplane hits a deer (yes, it has happened), how do you categorize that?

      What's the code for a concussion and skull fracture from a pileated woodpecker? It's an odd one, but surely more likely than spacecraft collision.

    69. Re:Good for insurance by bws111 · · Score: 1

      You completely missed the point. Nobody went through that list and said 'I think we should add struck by turtle'. Instead, they classified a turtle as an animal, and said all animals can bite and strike. When you automatically combine all the animals with all the things animals can do, you get some weird combinations. Struck by turtle (which btw means the turtle hit you, not you were hit with a turtle) makes little sense, but struck by bear makes perfect sense, and is liable to to cause various internal and external injuries.

      Same with your water ski and spacecraft examples. Water skis and spacecraft are types of vehicles. Vehicles can crash and burn among other things. No-one consciously thought 'better add burning water skis to the list'.

      If an airplane hits a deer the code would be 'aircraft, collision with other object'. If a woodpecker gives you a concussion it would be 'struck by bird' plus whatever the code is for concussion. It isn't all that difficult.

      What you apparently don't understand is that the codes are like mini sentences, with part of the code being the noun (turtle) and another part being the verb (bite). Yes, you can put together some bizarre sentences.

    70. Re:Good for insurance by sjames · · Score: 1

      What you apparently don't understand is that the codes are like mini sentences, with part of the code being the noun (turtle) and another part being the verb (bite). Yes, you can put together some bizarre sentences.

      Then why is there no code for bitten by a lamppost or crashing a turtle? If it is indeed based on composed subject-verb pairs, there would be such a pair, however silly. Also, the code numbers reflect only single digit encoded fields within a group. It's just not flexible enough to include arbitrary pairings. Someone ACTUALLY went through all of this. let's see, we need 10 types of vehicle and 10 types of medical events for each.

      Struck by bird doesn't really cover the woodpecker pecking your skull from a medical perspective (which you claimed was the point). It's a vastly different injury than (for example) a wren bumping in to you in flight. So in spite of the level of specificity, it still manages to capture a great mass of irrelevancy while missing relevant information (as any such system is doomed to).

      As for spacecraft, I sincerely doubt any hospital anywhere has dealt with victims of spacecraft crash, fire, being struck by, bitten by, or any other sort of thing other than 'while constructing" or "while repairing/preparing" (neither of which are available codes) as a billable event. As far as we know, there have been 3 casualties involving fire on a spacecraft but they unfortunately didn't go to the hospital.

    71. Re:Good for insurance by Rich0 · · Score: 1

      That's because as far as I can tell nobody really uses them in this way.

      I doubt most doctors would use separate codes for turtle bites, cat bites, dog bites, and termite bites. Most likely they'd just figure out what the code is for animal bite and use it for everything. Or maybe the code for "bleeding wound" or "puncture wound" or something.

      Just because you give somebody 140k choices in a drop-down doesn't mean that they actually sincerely try to find the one that best fits. Unless picking the right option actually changes how much they get paid they're not going to bother.

    72. Re:Good for insurance by bws111 · · Score: 1

      Are you really this dense, or are you just trolling? If there are 10 types of vehicle, and 10 types of events for vehicles, and 3 types of doctor visits, you need to enter a grand total of 23 items, which makes 300 codes. Nobody is ACTUALLY going through and entering 300 different codes.

      Next, ever hear of 'context'? In the context of 'Animal' a '1' can mean 'bite' while at the same time it means 'crash' in the context of 'Vehicle'. So no, you can not encode bitten by lamppost or injured in a turtle crash.

      The system is not designed to perfectly capture every possible scenario. No system can do that. It is designed to provide ENOUGH information to be useful to the people who use it (researchers, doctors, health agencies, insurance, etc). The alternative is natural language, which, until systems like Watson are pervasive, is completely unsuitable for searching, categorizing, research, etc and even with Watson is probably useless internationally when different languages are involved. And even with natural language you STILL have to use the right codes (words) and spell them correctly.

      Finally, these codes are not used only for living patients, they are also used for cause of death. So spacecraft does belong there.

      Instead of making ill-informed rants, why don't you look at the actual purpose of these codes.

    73. Re:Good for insurance by sjames · · Score: 1

      Are you really this dense, or are you just trolling? If there are 10 types of vehicle, and 10 types of events for vehicles, and 3 types of doctor visits, you need to enter a grand total of 23 items, which makes 300 codes. Nobody is ACTUALLY going through and entering 300 different codes.

      Why no, I'm not. Are you really an insulting moron who was raised by wolves or do you just play one on /.?

      Next, ever hear of 'context'? In the context of 'Animal' a '1' can mean 'bite' while at the same time it means 'crash' in the context of 'Vehicle'. So no, you can not encode bitten by lamppost or injured in a turtle crash.

      You're the one who claimed it was just encoded subjects and verbs and that they combined arbitrarily,. NOW you claim there's some actual context? Why doesn't context eliminate the hit by turtle, flaming skis, or any of the other silly combinations?

      Tie logic into Gordian knots all you want, the codes are still a silly child's game being played by adults who apparently have nothing better to do. Sensible people would just use keywords for searches. That way if someone invents a device called a flugalwhumper and it starts hurting people, you can actually research it rather than having it all lumped under other along with the flaming tortoise bites.

      The sad part is that all of this increases the cost of health care for all at a time when increasing numbers of people can't afford it.

  3. How does it actually work? by Anonymous Coward · · Score: 0

    How do you manage to search for the exact sonfition in 140k conditions?

    1. Re:How does it actually work? by Tridus · · Score: 2, Interesting

      We're talking about bureaucrats here. They never think about details like that.

      I've dealt with similar nonsense when buliding systems before. Seven pages of codes to classify a file, most of which never get used because it was far too complicated for the users to figure out... and they don't think it's specific enough.

      And I say that as a government employee. This type of nonsense goes on all the time.

      --
      -- "So they told me that using the download page to download something was not something they anticipated." - Bill Gates
    2. Re:How does it actually work? by Andrewkov · · Score: 1

      And in other news, all accidents are caused by code 1 - Unknown Accident.

    3. Re:How does it actually work? by Anonymous Coward · · Score: 0

      I don't think I understand what you're trying to say. Could you please be a little more specific?

    4. Re:How does it actually work? by Jeremy+Erwin · · Score: 5, Informative

      I believe you start with the most general, such as
      C Malignant Neoplasms
      and add details
      C71 Malignant neoplasm of brain
      C71.4 Malignant neoplasm of brain, Occipital lobe

  4. tag based system by FunkyELF · · Score: 2

    Wouldn't a tag based system be more effective than trying to exhaustively list 140,000 things?
    Or can each of these 140,000 be used in a combination?

    What if you walked into a lamp post, fell and hit your head on a turtle, it got angry and bit your ear?

    1. Re:tag based system by ColdWetDog · · Score: 2

      Wouldn't a tag based system be more effective than trying to exhaustively list 140,000 things?
      Or can each of these 140,000 be used in a combination?

      What if you walked into a lamp post, fell and hit your head on a turtle, it got angry and bit your ear?

      Yes, you can use them in combination.

      You CAN be injured by a turtle, struck by lightening and suffer traumatic brain injury and a hernia. On a plane. On an experimental plane. On the runway.

      This would engender a number of codes and would be indicative of very, very bad karma. Or perhaps God really does have a sense of humor.

      --
      Faster! Faster! Faster would be better!
    2. Re:tag based system by Anonymous Coward · · Score: 0

      >>What if you walked into a lamp post, fell and hit your head on a turtle, it got angry and bit your ear?

      This is no laughing matter. Turtle-lamp-ear accidents are up an infinite percentage this year.

    3. Re:tag based system by elsurexiste · · Score: 1

      What if you walked into a lamp post, fell and hit your head on a turtle, it got angry and bit your ear?

      You are right, we are not precise enough. We should reevaluate the whole lot and add such obvious mishaps.

      --
      I rarely respond to comments. Also, don't ask for clarifications: a brain and Google are faster, believe me!
    4. Re:tag based system by gilleain · · Score: 1

      Wouldn't a tag based system be more effective than trying to exhaustively list 140,000 things? Or can each of these 140,000 be used in a combination?

      What if you walked into a lamp post, fell and hit your head on a turtle, it got angry and bit your ear?

      In fact, if you are a trumpeter at the opera, and a turtle bites you so that you walk into the scenery, which happens to be a lamppost...

    5. Re:tag based system by dgatwood · · Score: 1

      This is no laughing matter. Turtle-lamp-ear accidents are up an infinite percentage this year.

      Well, I don't know how many times it happened this year, but I bet I can tell you how many times it happened last year.

      --

      Check out my sci-fi/humor trilogy at PatriotsBooks.

    6. Re:tag based system by limbodog · · Score: 1

      They actually can be used in combination. For professional claims (private doc offices, labs, etc) I think you can have 13 codes, and for hospital claims you can have 25 or so.

    7. Re:tag based system by HermDog · · Score: 1

      Yes, you can use them in combination.

      You CAN be injured by a turtle, struck by lightening and suffer traumatic brain injury and a hernia. On a plane. On an experimental plane. On the runway.

      This would engender a number of codes and would be indicative of very, very bad karma. Or perhaps God really does have a sense of humor.

      I would not like them on a plane. I will not eat them on a train.
      I do not want them in my house. I can not feed them to a mouse.
      I do not like Green Eggs and Ham. I do not like them Sam-I am.

      --
      JADBP
    8. Re:tag based system by Anonymous Coward · · Score: 0

      Good grief -- someone has drank too much of the Orthogonal Defect Classification (ODC) system, and is applying it to medical billing.

      What is needed is more of an Object Oriented (OO) approach instead. Where things can be classified at a higher (more general) level, and insurance companies can come back for a more specific classification (IF NEEDED!).

      Medical/Insurance billing is a huge monstrosity, and probably a large part of why medical costs in the US are so high.

      "What if you walked into a lamp post, fell and hit your head on a turtle, it got angry and bit your ear?"

      Who cares how the injury occurred? -- the classification should be:
                Head Injury --> Superficial --> Bandages Applied

      And bill me the $45 bucks to make things good. Instead, this guy would probably be billed a couple grand.

    9. Re:tag based system by bdenton42 · · Score: 1

      What if you walked into a lamp post, fell and hit your head on a turtle, it got angry and bit your ear?

      Looks like at least five codes for that one:

      1. W22.02 Walked into lamppost
      2. W59.21 Other contact with turtle
      3. S00.93 Contusion of unspecified part of head
      4. W59.29 Bitten by turtle
      5. S01.351 Open bite of right ear or S01.352 Open bite of left ear
    10. Re:tag based system by sjames · · Score: 1

      What if you're bitten by a tortoise?

      What if you get bitten by a ladybug and due to your distraction, bump into a lamp-post causing you to stumble into the bear trap the crazy homeless person is using to catch the space aliens that pester him every night? At that point, the ocelot that recently escaped from the zoo scratches your arm just for the hell of it? Is there a code for that?

      I recently saw on DFH a woman who believed there were demons in her liver and gave herself rhabdomyolysis trying to squeeze them out with her abdominal muscles. The doctor called in a priest from the nearby cultural center to perform the necessary exorcism so the woman would stop overworking the muscles. What's the code for liver demons?

    11. Re:tag based system by Sarten-X · · Score: 1

      What's the code for liver demons?

      Being far too lazy to look up the actual codes, it's something like a combination of rhabdomyolysis + self-inflicted + religion. I think there's an E code for religion...

      --
      You do not have a moral or legal right to do absolutely anything you want.
  5. TMNT by Anonymous Coward · · Score: 0

    Is it the same code for regular turtle injuries and ninja turtle injuries?
    What if I am attacked by a renaissance artist, will that have the same code as the ninja turtle injury and if not, how do I know which one to use?

  6. What is the code for burns via shark? by clonan · · Score: 2

    I need to know in case a henchman falls into the tank...

    1. Re:What is the code for burns via shark? by Anonymous Coward · · Score: 0

      uhhh...lasers....

    2. Re:What is the code for burns via shark? by blueg3 · · Score: 4, Funny

      W5649XA
      W902XXA

    3. Re:What is the code for burns via shark? by stubob · · Score: 3, Informative

      W56.49 "Other encounter with shark" + W90.2 "Exposure to laser radiation" is all I've got.

      --
      Planning to be moderated ± 1: Bad Pun.
    4. Re:What is the code for burns via shark? by ColdWetDog · · Score: 2

      I need to know in case a henchman falls into the tank...

      Dear Dr. Evil:

      Your recent Workman's Compensation claim has been returned to your office for further processing. We need additional information before we can later reject it out of hand. The description of a coworker falling into the shark tank needs to be clarified.

      Please describe whether the shark came in contact with coworker (ICD 10 CM code W56.42XA for initial contact, W56.49XD for any subsequent encounters), was actually bitten by the shark (W56.42XA initial bite, W56.41XD subsequent bites) or merely struck by the animal (W56.42XA initial, W56.42DX subsequent). If lasers were involved, please additionally code W90.2XXA (Exposure to laser radiation, initial encounter) or W90.2XXD (subsequent) as appropriate.

      In reviewing previous similar claims, it appears that your employees have had similar issues with Sea Bass. Since a Sea Bass has a different code than a Shark, you would use W56.51XA (Bitten by fish, initial encounter) or W56.51DX (subsequent bites) or if the Sea Bass just hit the employee code as Other Contact with Fish (W56.59XA or XD as appropriate).

      Of course, these codes exclude any poisonous Shark or Sea Bass. If this was noted, please contact the World Health Organization for further guidance.

      We hope we may be of continued service to you.

      Sincerely,

      EvilOverlord Insurance Company
      "More Evil than you could ever be"

      --
      Faster! Faster! Faster would be better!
    5. Re:What is the code for burns via shark? by ColdWetDog · · Score: 2

      Can anybody tell who's been to a recent ICD-10 coding seminar?

      --
      Faster! Faster! Faster would be better!
    6. Re:What is the code for burns via shark? by Anomalyst · · Score: 2

      What is the ICD-10 code for Seminar induced narcolepsy?

      --
      There is no right to feel safe thru security vaudeville at the expense of everyone's freedom, privacy and tax money.
    7. Re:What is the code for burns via shark? by SleazyRidr · · Score: 2

      Wait, there's a genuine code for "Other encounter with shark"?

    8. Re:What is the code for burns via shark? by Anonymous Coward · · Score: 0

      This pairs well with the codes for burns due to waterskis on fire (V9107XD).

    9. Re:What is the code for burns via shark? by Anonymous Coward · · Score: 0

      Why is there no code for "Mauled by bear, initial encounter?" Everyone knows bears have had it out for us.

    10. Re:What is the code for burns via shark? by Lemmeoutada+Collecti · · Score: 2

      WICD10.01X for the initial nap, WICD10.01XA for subsequent, and since this seminar obviously included sharks, W56.42EXA for inability to find sharks exciting. In case of further symptoms related to W56.42EXA and related codings, consult the PDR to determine if the conditional is pathological, psychological, meteorological, or meta-logical.

      Cases where meta-logical stress induced psychological pathology is indicated should be admitted to trauma care within one hour to prevent further loss of cognitive faculties and potential decrease in billable coding according to EMCR401-36 subsection ii(a).

      If unable to determine the exact morphology of the shark, repeated cranial impact stimulation using a arboreal mesh imprinted with all potential ICD codes is required. Avoid stimulation of the frontal and prefrontal cortices unless patient displays negative reactions to application on the posterior sinister epidural surfaces.

      If in doubt of final diagnosis, select all available codes and notify the patient's HMO, secondary insurance provider, preferred mortician, and nearest organ donor collection facility. Ensure that the patients organ donor card is completed properly to ensure prompt and accurate payment for donated organs.

      --

      You can have it fast, accurate, or pretty. Pick any 2.
    11. Re:What is the code for burns via shark? by Anomalyst · · Score: 2

      I assume taco bell bean burrito induced flatulence (whatever the code is for that) is cause for considering a posterior to be sinister?

      --
      There is no right to feel safe thru security vaudeville at the expense of everyone's freedom, privacy and tax money.
    12. Re:What is the code for burns via shark? by Alsee · · Score: 4, Informative

      Just to expand on that, I looked up the full titles for those codes:
      W5649xA Other contact with shark, initial encounter
      W902xxA Exposure to laser radiation, initial encounter

      -

      --
      - - You can't take something off the Internet! That's like trying to take pee out of a swimming pool.
    13. Re:What is the code for burns via shark? by tivoKlr · · Score: 2

      There'll always be "other" no matter how many codes the ICD contains.

      --
      Ocean is land, covered with water.
  7. This isn't really interesting by mat+catastrophe · · Score: 5, Funny

    ICD-9 had codes for masturbation.

    Go ahead and think about why I might know that. Scar yourselves.

    --
    sig not found
    1. Re:This isn't really interesting by Anonymous Coward · · Score: 0

      Because your penis was damaged by the fan blades in a vacuum?

    2. Re:This isn't really interesting by Anonymous Coward · · Score: 0

      Well, ICD-10 does not have that, strangely. But they do have these:

      Z7251 High risk heterosexual behavior
      Z7252 High risk homosexual behavior
      Z7253 High risk bisexual behavior

      Guess soon comes denying your medical care because of your sexual orientation.

    3. Re:This isn't really interesting by RNLockwood · · Score: 1

      No thanks, I'm not into self mutilation.

      --
      Nate
    4. Re:This isn't really interesting by wisty · · Score: 1

      Did you realize before or after you took the pen from the "lost and found" box?

    5. Re:This isn't really interesting by Toonol · · Score: 1

      In any specific injury, how do they distinguish 'bisexual' from either 'heterosexual' or 'homosexual'?

    6. Re:This isn't really interesting by Anonymous Coward · · Score: 0

      Did you realize before or after you took the pen from the "lost and found" box?

      An unfortunate side effect of misreading a common saying as "the penis mightier than the sword.".

    7. Re:This isn't really interesting by Reverand+Dave · · Score: 1

      If we gotta explain it to you son, you won't understand.

      --
      I got here through a series of tubes
    8. Re:This isn't really interesting by J'raxis · · Score: 1

      The system seems designed to encode what the patient tells the doctor about the cause of the injury, not just information relevant to treating the injury. (It's a government-designed system, big surprise.) So if the doctor knows their sexual orientation, it'll get encoded in the injury code.

      Just like the "walked into a lamp-post" one. Does it matter if it was a lamp-post as opposed to a telephone pole, a sign-post, or a mailbox? No, but they'll still encode that particular detail.

    9. Re:This isn't really interesting by Anonymous Coward · · Score: 0

      ICD-9 had codes for masturbation.

      Go ahead and think about why I might know that. Scar yourselves.

      Uh . . . because your a medical biller, perhaps?

    10. Re:This isn't really interesting by Cl1mh4224rd · · Score: 1

      ICD-9 had codes for masturbation.

      Go ahead and think about why I might know that. Scar yourselves.

      What's the medical code for that?

      --
      People will pass up steak once a week, for crap every day.
    11. Re:This isn't really interesting by Khashishi · · Score: 1

      A doctor tells me that hospitalization for having objects stuck in the anus from people "falling" on them is fairly common, and they have a drawer full of stuff pulled out of people's asses. I have no idea why they would keep those things.

    12. Re:This isn't really interesting by TheSpoom · · Score: 1

      Guess soon comes denying your medical care because of your sexual orientation.

      I'd guess the specificity of sexual orientation was requested by the MIB for exactly the reason you mentioned.

      (And yes, that's a real thing.)

      --
      It's better to vote for what you want and not get it than to vote for what you don't want and get it.
      - E. Debs
    13. Re:This isn't really interesting by Anonymous Coward · · Score: 0

      Which one is "Death by Cheney"?

    14. Re:This isn't really interesting by Bucky24 · · Score: 1

      AFAIK masturbation isn't a medical condition. Chronic masturbation on the other hand.... "Other contact with hand" maybe?

      --
      All the world's a CPU, and all the men and women merely AI agents
    15. Re:This isn't really interesting by St.Creed · · Score: 1

      They come in handy on those long, cold nights when first aid workers start telling each other stories about who pulled what out of whose anus :)

      --
      Therefore, by the (faulty) logic you're using, you're just a cow with a keyboard - osu-neko (2604)
    16. Re:This isn't really interesting by corbettw · · Score: 1

      You want me to abuse myself by thinking about you masturbation?

      --
      God invented whiskey so the Irish would not rule the world.
    17. Re:This isn't really interesting by itsenrique · · Score: 0

      well if its a dude and it involves his butt you can be pretty sure it wasn't fully hetero. if a chick is lacerated from a strap on you can also say thats not straight. as far as how it could be a "bisexual" injury though, seems like you'd have to be going for both at once....

    18. Re:This isn't really interesting by Anonymous Coward · · Score: 0

      What's the ICD-10 code for that?

    19. Re:This isn't really interesting by mat+catastrophe · · Score: 1

      In the ICD-10 it's x:78 - Intentional self-harm by sharp object

      Although I wonder if that applies to scarification...sounds more like just going all stabby-stabby.

      --
      sig not found
  8. Turtle Shell by Marxom · · Score: 1

    I assume "Struck by turtle" is an indicator of being hit by a turtle shell thrown by a fat Italian man named Mario

    1. Re:Turtle Shell by Anonymous Coward · · Score: 0

      I assume "Struck by turtle" is an indicator of being hit by a turtle shell thrown by a fat Italian man named Mario

      That's right. And the code for the same event with Luigi is $code + 1. The same even with a non-Italian with any name is $code / 10 + 3 * 2.

      If you were in an accident where a laptop computer burned your legs via slow thermal overheat, followed by a trip to the hospital where the ambulance wrecked and threw your body forward in the vehicle so that the top of your head was injured (but nothing else on your body aside from the "pre-existing" thermal burn), subsequently followed by the transfer from the first wrecked ambulance to another ambulance where a bystander spat into your eye, damaging your EYELID, but no other part of the eye, with food remnants in bystander's mouth (tobacco leaf remnants are not included)..... HEY! That's code number 3!!!!!!! Wow, it must be common.

      Oh, and code 3 is not required to be covered by any insurance company. :}

  9. Make it simple by Serenissima · · Score: 0

    Tag 1: They got hurt because they did something stupid and/or reckless Tag 2: They got hurt because someone around them did something stupid and/or reckless That should cover most things.

    --
    Give a man a fire and he'll be warm for a day. But light a man on fire and he'll be warm for the rest of his life.
    1. Re:Make it simple by i+kan+reed · · Score: 1

      Complete nonsense. Rather than mod you down, I'd just like to point out that natural circumstance can and frequently does circumvent any level of planning or recklessness engaged in by people. You CAN be severely injured by a lightning strike from a clear sky. Not every injury can be blamed on a lack of responsibility,

      Moreover, the importance of classifying injuries goes beyond insurance, and doctors can use these codes to help identify specialties that are applicable to a patient.

    2. Re:Make it simple by Anonymous Coward · · Score: 0

      So which specialty is it that specifically needs to filter patients on whether they were hit by a turtle? Are some doctors specialized in lamp-post-related injuries?

    3. Re:Make it simple by Wyatt+Earp · · Score: 1

      I had cancer, which of your two tags covers that?

    4. Re:Make it simple by SydShamino · · Score: 3, Insightful

      There are people who believe that, if something bad happens to someone, then that person did something to deserve it. The action to "earn" punishment might be reckless behavior, or the punishment could be divine retribution, but either way bad things only happen to bad people.

      For that type of people, it's a justification for their belief that no one ever deserves a safety net in case all else fails. You might find that this drives certain political views.

      --
      It doesn't hurt to be nice.
    5. Re:Make it simple by Anonymous Coward · · Score: 0

      That won't work. Most police department will not assign fault as they don't want the liability. The officers will phrase things so that their opinion is known and the lawyers can read behind the line and if they're all above board ensure things go correctly. If muncipalities don't want that liability, could you see a hospital assuming it? ALl it would take is a few people to sue saying they weren't doing something stupid and no hospital would use that tag anymore.

      Also, some times you legitimately don't know. One Sunday I picked my daughter up from her visitation from her mother; on the way home she complained of a head ache, blurred vision, feeling nauses, etc. I asked her when she started and she told me since the car wreck. After the WTF moment passes, I asked what car wreck etc and took her to the emergency room where she was diagnosed with a concussion and a sprained wrist.

      My health insurance refuses to pay the bill as they feel the person at fault for the accident should have to cover it. There is no police report because the officer present said there were no injuries and that one vehicle was standing still and the other one had stopped and was only moving forward due to the dirvers foot coming off the brake with no acceleration so they were going to slow to cause a concussion. Dr.'s have disagreed, but since the police officer said that, they won't tell me who the other driver is. I tried family court in that my ex is obligated to tell me about things like my daughter, but I can't prove the concussion was a result of the accident as it was daignosed two days later and the police officer says there were no injuries so they won't force her to tell me the details so I can try and track this person down.

    6. Re:Make it simple by tepples · · Score: 2

      It depends on who was smoking the cigarettes.

    7. Re:Make it simple by tmosley · · Score: 1

      Insurance agents?

    8. Re:Make it simple by tmosley · · Score: 1

      Was it an accident?

      Then you got cancer on purpose! No coverage for you!

    9. Re:Make it simple by Wyatt+Earp · · Score: 1

      Not all cancer comes from cigarette exposure. So tags 1 and 2 still don't apply.

    10. Re:Make it simple by Bill_the_Engineer · · Score: 1

      It would be more accurate to say:

      Bad things can happen to anyone. The probability of a bad thing happening is proportional to the risky behavior exhibited by the subject. For example there have been cases of people being struck by lightning 10 miles away from a thunderstorm in this case the victim perceived that there was clear sky above. However the probability of that happening is significantly lower than the probability of a groin injury happening to a person who likes to skateboard on hand rails.

      So you are both right.

      --
      These comments are my own and do not necessarily reflect the views or opinions of my employer or colleagues...
    11. Re:Make it simple by Jeremy+Erwin · · Score: 1

      Tag 3: God was being stupid and/or reckless.

    12. Re:Make it simple by gknoy · · Score: 1

      It's your own fault for being born in Hinkley.

    13. Re:Make it simple by i+kan+reed · · Score: 5, Informative

      I just learned about this kind of injury recently. Apparently sea turtle rape of scuba divers is a not-as-uncommon-as-you-might-think issue, with drowning, compression/decompression sickness, and trauma being common effects, as sea turtles will force divers to the bottom of the ocean and hold them their for as much as an hour. Without being an expert myself, I'd wager cardio-respritory care would be needed in addition to trauma treatment.

      This post is not intended to be humorous, this is an actual, serious issue I learned about with loggerhead turtles recently.

    14. Re:Make it simple by Anonymous Coward · · Score: 0

      This is very true among most U.S. Christians.

    15. Re:Make it simple by kenj0418 · · Score: 3, Funny

      You CAN be severely injured by a lightning strike from a clear sky.

      Hmm, let me check my list:
      S444.11 Smote - Fire, Pillar from sky
      S444.12 Smote - Fire, Spontaneous Combustion
      S444.2 Smote - Salt, Transformation into pillar
      S444.3 Smote - Lightning

      Ahh, there it is.

    16. Re:Make it simple by skids · · Score: 2

      The probability of a bad thing happening is proportional to the risky behavior exhibited by the subject.

      More like "the probability of a bad thing happening contains a term which is proportional to risk behavior exhibited by the subject." No amount of risky behavior is going to affect your chances of being hit by an uncharted meteor.
      .

    17. Re:Make it simple by SydShamino · · Score: 1

      Statistically, some percentage of people who try something "risky" will fail. Is it the fault of those people that they fail? Sometimes, maybe, but not every time.

      And sometimes bad things happen to people who did nothing risky, or at least riskier than living and breathing within the means afforded them by their parentage and intelligence.

      This is why I believe in a social safety net.

      --
      It doesn't hurt to be nice.
    18. Re:Make it simple by SydShamino · · Score: 1

      My opinion was concurring, not dissenting. I did agree with him.

      --
      It doesn't hurt to be nice.
    19. Re:Make it simple by Anonymous Coward · · Score: 0

      Yes, the speciality is known as a lampologist with a focus on reptiliology.

    20. Re:Make it simple by Walkingshark · · Score: 1

      Wow, can you imagine if a loved one was raped to death by a sea turtle. I mean, I don't care how somber you are, if someone looks at you all serious and they're like, "My Dad was raped to death by a sea turtle," you're not going to be able to stop yourself before at least a little giggle escapes.

      --
      The world you experience is only a close approximation of reality.
    21. Re:Make it simple by Bill_the_Engineer · · Score: 1

      Okay. I was agreeing with you both. I was just clarifying your point. Sometimes intent is hard to express using forums.

      --
      These comments are my own and do not necessarily reflect the views or opinions of my employer or colleagues...
    22. Re:Make it simple by Bill_the_Engineer · · Score: 1

      This is why I believe in a social safety net.

      So do I. A certain political party preaches pulling one's self up by the boot strap. This would imply that they are encouraging people to assume risk for a potential payoff. It seems illogical that they would encourage people to be entrepreneurs or investors while removing these social safety nets. It's as if they are just catering to the ones who already took the risk and succeeded or are descendants of robber-barons at the expense of future new wealth.

      --
      These comments are my own and do not necessarily reflect the views or opinions of my employer or colleagues...
  10. Why stop at 140,000? by bigredradio · · Score: 2

    Why stop at 140,000? There are an infinite number of ways you can get hurt. I think that the most common injuries could be classified within the 18,000 codes. All other injuries should be labeled 'misc'. The additional cost and confusion out weighs the benefit. Once you open the door to classifying EVERY injury, you will get a lot of duplicates because of mistakes and misspellings. Code 999 = Hit by potato gun. Code 1256 = Injured shooting a potatoe gun.

    1. Re:Why stop at 140,000? by Anonymous Coward · · Score: 0

      Technically those two are different. You can hurt yourself as your spud gun misfires, or you can hurt someone else as your spud gun fires properly and hits.

    2. Re:Why stop at 140,000? by Anonymous Coward · · Score: 0

      Code 1256 = Injured shooting a potatoe gun.

      Dan Quayle? Is that you?

    3. Re:Why stop at 140,000? by Anonymous Coward · · Score: 0

      Well, no in both cases a person gets hit by a potato gun. In your case someone gets hit by the projectile.

      We need a new code here, hit by projectile fired from correctly working potato gun.

    4. Re:Why stop at 140,000? by Rennt · · Score: 1

      Not to be confused with Code 1000 = Hit by potatoe gun, and Code 1257 = Injured by shooting a potato gun. DETAILS PEOPLE!

    5. Re:Why stop at 140,000? by Duradin · · Score: 1

      Codes specifically involving Quayle seem almost too detailed.

    6. Re:Why stop at 140,000? by Anonymous Coward · · Score: 0

      Code 128943 - Broken bone due to assault by politician
      Code 128944 - Mental trauma due to assault by politician
      Code 128945 - Mental trauma due to proximity to Vice President

      It's close, but unfortunately there still won't be a way to tell if more incidences of 128945 occur because of Quayle, Cheney, or Biden.

    7. Re:Why stop at 140,000? by Anomalyst · · Score: 1

      What is the code for being shot in the face by a Vice Preesident?

      --
      There is no right to feel safe thru security vaudeville at the expense of everyone's freedom, privacy and tax money.
    8. Re:Why stop at 140,000? by Rennt · · Score: 1

      Depends. "Accidentally shot in the face by VP" is a different thing entirely to "Deliberately shot in the face by VP"... and that's before we even consider the type firearm.

    9. Re:Why stop at 140,000? by davidbrit2 · · Score: 1

      Depends. It's a different one for Cheney.

    10. Re:Why stop at 140,000? by Anonymous Coward · · Score: 0

      Why stop at 140,000? There are an infinite number of ways you can get hurt. I think that the most common injuries could be classified within the 18,000 codes. All other injuries should be labeled 'misc'. The additional cost and confusion out weighs the benefit.

      What cost is added by having an additional database entry?

      Once you open the door to classifying EVERY injury, you will get a lot of duplicates because of mistakes and misspellings. Code 999 = Hit by potato gun. Code 1256 = Injured shooting a potatoe gun.

      Feel free to look at the 140,000 codes and find a single instance of such a thing.

    11. Re:Why stop at 140,000? by Anonymous Coward · · Score: 0

      Why stop at 140,000? There are an infinite number of ways you can get hurt.

      No one is stopping. ICD-11 is available for viewing online. It takes time to change the way all the medical systems of the world operate.

      All other injuries should be labeled 'misc'.

      The reason we use this system is so we can study our diseases in detail. Throwing a huge chunk of them in one pile would defeat that purpose.

      The additional cost and confusion....

      This is an obvious assumption, but it's not true. Adding more results to the database makes it easier to choose accurate codes.

      you will get a lot of duplicates because of mistakes and misspellings. Code 999 = Hit by potato gun. Code 1256 = Injured shooting a potatoe gun.

      That's not at all how the ICD system works.

      It's certainty got problems, but it lets us study our weaknesses. It could use some more good critics, but you need to learn how and why it works first.

    12. Re:Why stop at 140,000? by Anonymous Coward · · Score: 0

      But what's the code for being hit by the potato fired by the gun?

  11. Flaming Skis by Jodka · · Score: 3, Interesting

    My favorites:

    V9107XA Burn due to water-skis on fire, initial encounter
    V9107XD Burn due to water-skis on fire, subsequent encounter
    V9107XS Burn due to water-skis on fire, sequela

    --
    Ceci n'est pas une signature.
    1. Re:Flaming Skis by Anonymous Coward · · Score: 0

      What is "Other contact with turtle"? They're so... How do you.... Would it fit in...... How long would it......??

    2. Re:Flaming Skis by Errol+backfiring · · Score: 1

      Didn't you know? Its turtles all the way down...

      --
      Nae king! Nae laird! Nae yurrupiean pressedent! We willna be fooled again!
    3. Re:Flaming Skis by dmmiller2k · · Score: 1

      Even better:

      V9027XA Drowning and submersion due to falling or jumping from burning water-skis, initial encounter
      V9027XD Drowning and submersion due to falling or jumping from burning water-skis, subsequent encounter
      V9027XS Drowning and submersion due to falling or jumping from burning water-skis, sequela

      --

      "No matter how cynical you get, it is impossible to keep up." -- Lily Tomlin

    4. Re:Flaming Skis by DCFusor · · Score: 0
      This was on NPR this morning, early. So give credit! Actually, what they claim as justification for this huge mess is that if they now have real specifics about why people are going to the doctor, they can then engage in "prevention" as in -- make skis illegal to stop this horrible epidemic.

      This in fact is the single best argument against government funded health care in any guise (including forcing us to use the existing broken rapacious insurance system in the most blatant crony capitalism ever shown in public)

      Because once everyone's on the dole, and "the government" eg us, are paying for it, there's no end of temptation for them to tell us how to live in detail, to keep profits high and costs down. A world of everything not mandatory being forbidden is where this goes inevitably. Fight it, or suck it up, but realize what's coming so you can do it honestly.

      --
      Why guess when you can know? Measure!
    5. Re:Flaming Skis by davidbrit2 · · Score: 1

      Some people just don't learn their lesson the first time they try to water ski while re-entering Earth's atmosphere.

    6. Re:Flaming Skis by Jeremy+Erwin · · Score: 1

      It's a logical continuation of

      V9022XA Drowning and submersion due to falling or jumping from burning fishing boat, initial encounter
      V9022XD Drowning and submersion due to falling or jumping from burning fishing boat, subsequent encounter
      V9022XS Drowning and submersion due to falling or jumping from burning fishing boat, sequela

    7. Re:Flaming Skis by SleazyRidr · · Score: 1

      I like:
      V95.4 Spacecraft accident injuring occupant

    8. Re:Flaming Skis by MiniMike · · Score: 1

      Is it the same code if the water-skis were set on fire by a turtle?

    9. Re:Flaming Skis by icebraining · · Score: 2

      Yet countries with real government health systems like those here in Europe have often less restrictions on such things (where I live consuming drugs - any drugs - is not a crime, for example).

      So, how does this fit in that view?

    10. Re:Flaming Skis by Anonymous Coward · · Score: 0

      A search for "alien" turns up nothing; but if you take the 'n' off, the last one is:

      Z1379 Encounter for other screening for genetic and chromosomal anomalies

      Alien-human hybrids. You know it.

    11. Re:Flaming Skis by Alsee · · Score: 1

      No, I'm not some spaz looser who fell down and almost drowned while attempting to water ski. And I can prove it. Here's my medical paper work:

      V9227XA Drowning and submersion due to being washed overboard from water-skis, initial encounter

      I was washed overboard!

      -

      --
      - - You can't take something off the Internet! That's like trying to take pee out of a swimming pool.
    12. Re:Flaming Skis by sjames · · Score: 1

      We can combine that with:

      W5649xA Other contact with shark, initial encounter

      W902xxA Exposure to laser radiation, initial encounter

      Into a master code for medical code system has jumped the shark with frickin lasers on it's head on flaming water skis and be done with it.

    13. Re:Flaming Skis by cmich · · Score: 1

      V9027XA Drowning and submersion due to falling or jumping from burning water-skis, initial encounter
      V9027XD Drowning and submersion due to falling or jumping from burning water-skis, subsequent encounter
      V9027XS Drowning and submersion due to falling or jumping from burning water-skis, sequela

    14. Re:Flaming Skis by bdenton42 · · Score: 1
      Youchies...

      V97.33 Sucked into jet engine

    15. Re:Flaming Skis by Anonymous Coward · · Score: 0

      Pfft, don't get burned by flaming water-skis, jump off and drown instead

      V9027XA: Drowning and submersion due to falling or jumping from burning water-skis, initial encounter
      V9027XD: Drowning and submersion due to falling or jumping from burning water-skis, subsequent encounter
      V9027XS: Drowning and submersion due to falling or jumping from burning water-skis, sequela

  12. And now to suit our great computer by countertrolling · · Score: 1

    You're magnetic ink

    --
    For justice, we must go to Don Corleone
  13. Oblig. Oscar Wilde by lobiusmoop · · Score: 2

    "Bureaucracy expands to meet the needs of the expanding bureaucracy. "

    --
    "I bless every day that I continue to live, for every day is pure profit."
    1. Re:Oblig. Oscar Wilde by Reverand+Dave · · Score: 1

      As a mandate from the Department of Redundancy Department.

      --
      I got here through a series of tubes
  14. Oblig. by Megahard · · Score: 1
    --
    I eat only the real part of complex carbohydrates.
    1. Re:Oblig. by Exitar · · Score: 1

      It should, google gives 13,100 results for that, so I assume it is a quite common way of dying.

  15. Now we have to start lying to our doctors? by jabberw0k · · Score: 1

    So would "Fell off balcony at opera" go under the same code as "Strained vocal chords at the opera"? Good grief. Your government in action.

    1. Re:Now we have to start lying to our doctors? by bws111 · · Score: 1

      Opera house is a place, not an injury or cause of injury. In both of your examples, the code for opera house would be used for the place of injury. There is nothing wrong with that. One of the injuries would also have 'broken left tibia' as the injury, and 'fall' as the reason for the injury. The other one of course would have different codes.

      The codes are just a language used to describe things so that computers can easily search, categorize, etc. Once computers that can understand 'fell off balcony at opera' (like Watson) become pervasive we won't need special codes to replace natural language.

      Not everything everyone does is some sign of inefficiency or stupidity.

  16. The title by Deatzo+Seol · · Score: 0

    It hurt my brain!

    --
    We are the music makers, and we are the dreamer of dreams. ~ Arthur O'Shaughnessy
    1. Re:The title by ColdWetDog · · Score: 1

      I'm sure there is a code for that.

      --
      Faster! Faster! Faster would be better!
  17. U.S. ICD-10 CM not the ICD-10 by iggymanz · · Score: 2

    Just to clarify, ICD-10 is maintained by the WHO. The clinical modifications to the ICD-10 in the USA are known as "US ICD-10 CM".
     
    Yes, they are very stupid

    I'm cranky about it because for one of my clients I design insurance adjudication and practice management systems.

    1. Re:U.S. ICD-10 CM not the ICD-10 by Registered+Coward+v2 · · Score: 3, Interesting

      Just to clarify, ICD-10 is maintained by the WHO. The clinical modifications to the ICD-10 in the USA are known as "US ICD-10 CM". Yes, they are very stupid

      However, from an epidemiological standpoint, having better information about the causes of health problems will allow better study of cause and effect relationships between wellness and disease, for example. Even if it is a pain to implement (there must be a code for that).

      --
      I'm a consultant - I convert gibberish into cash-flow.
    2. Re:U.S. ICD-10 CM not the ICD-10 by spasm · · Score: 1

      I use ICD-10 to look at fatal overdose using the national data provided by the CDC (google CDC Wonder compressed mortality file if you want to play with it). There's already a problem that there's at least 8 ways to code a fatal heroin overdose, and overworked coroner/medical examiner investigators are already prone to use the most generic and least specific ones to speed things up. Adding another 140,000 codes might be great for coding cause of non-fatal injury for insurance purposes, but for working out how rates of death from specific causes are changing and comparing them across states (or other common epidemological tasks) this new system is going to be a hideous nightmare.

    3. Re:U.S. ICD-10 CM not the ICD-10 by timeOday · · Score: 1

      I would like to hear more about why they are stupid. So far all I hear is "ugga, 140,000, big numbers bad!" But, decisions are driven by information. Doesn't somebody just enter some search terms and pick a few of the more appropriate hits, or is it more obnoxious than that? For somebody developing software such as yourself, isn't it just a matter of copying over the new codes file? Probably not, but I'd like it explained by somebody with more than a knee-jerk reaction.

    4. Re:U.S. ICD-10 CM not the ICD-10 by WuphonsReach · · Score: 1

      I would like to hear more about why they are stupid.

      Because people are involved in the coding. Which means that they will resort to using the most generic codes possible, simply because it's impossible to remember 140k codes (or even how to search in a way that you pull up all 140k codes).

      Time is money, time spent coding is wasted time. So the economic force will be to short-change coding time as much as possible. You won't have 5 minutes per code to sit and do searches, you'll have seconds (maybe a dozen or two at most) to categorize the injury and move on to the next code.

      Then there's the whole issue of everyone coding in a consistent manner. When you only have 10 slots, that's rather easy. When you get up into 140k different codes, a lot of which are subtlety different, it becomes much easier and much less apparent that something was coded incorrectly or inconsistently.

      --
      Wolde you bothe eate your cake, and have your cake?
    5. Re:U.S. ICD-10 CM not the ICD-10 by Bucky24 · · Score: 1

      or even how to search in a way that you pull up all 140k codes

      A search that pulls up all 140k codes is not working properly (unless that's what you wanted I suppose). A good search should pull up 10-20 codes.

      --
      All the world's a CPU, and all the men and women merely AI agents
    6. Re:U.S. ICD-10 CM not the ICD-10 by Syhra · · Score: 1

      However, from an epidemiological standpoint, having better information about the causes of health problems will allow better study of cause and effect relationships between wellness and disease, for example. Even if it is a pain to implement (there must be a code for that).

      This should intuitively be true. However, making assumptions about a population based solely on someone's ability to find the proper code will not garner the response you are looking for. If I see someone for a twisted ankle (alligator-induced), a common cold, dirt in the eye of extraterrestrial origin, and insulin dependent type 2 diabetes, it is much easier for me to put down the common cold (and perhaps diabetes mellitus, though no specific sub-classification) because I see it all the time and remember it. Most current applications only provide spaces for 3 diagnoses anyhow. ICD 9 gives 780 for general symptoms, and people with much more exacting diagnoses are given this code because it is easy to remember and can be used for almost any situation.

      Studies based on retrospective chart reviews often come up with bizarre correlations. Take autism and vaccinations, or acetaminophen and Type I diabetes for example.

    7. Re:U.S. ICD-10 CM not the ICD-10 by Registered+Coward+v2 · · Score: 1

      Studies based on retrospective chart reviews often come up with bizarre correlations. Take autism and vaccinations, or acetaminophen and Type I diabetes for example.

      Well, it's not that the correlation is bizarre as much as the idiots who confuse correlation with causation. But I do agree with your statement about the value of the data - it's only a stood as the data entry. Given the issues many hospitals / physicians / etc have with bad coding (and thus actually getting paid) there will be many problems with the data. Still, it would be nice to be able to try to see if wellness programs actually reduce the incident of specific health issues and the cost of health care.

      --
      I'm a consultant - I convert gibberish into cash-flow.
    8. Re:U.S. ICD-10 CM not the ICD-10 by Syhra · · Score: 1

      I would like to hear more about why they are stupid.

      Also because when you are trying to pull data, instead of using a handful of codes that encapsulate all the stuff you are trying to study, you have to perhaps draw from a much wider pool. Say you are looking for all ankle fractures - do you now look for ankle fractures, tibial fractures, fibular fractures, injuries caused by giraffes, falls from a height greater than 6.7m but less than 9.5m, etc. There is much potential crossover and yet it may not be fully inclusive of all you want to study. If people who studied in one location tend to code injuries from reptiles, while from another they specify turtles and we see a difference between the two groups, is it because reptiles are different than turtles, or because they were all turtles but one group treats turtle injuries better than the other.

      More information is not necessarily better. Case in point: Full body scans - we find more anomalies, but not necessarily more disease as that stone in your gallbladder may never have caused you problems, but now that it is known we are much more likely to want to take it out.

      I think this will result in a lower signal to noise ratio.

    9. Re:U.S. ICD-10 CM not the ICD-10 by Anonymous Coward · · Score: 0

      Just to clarify, ICD-10 is maintained by the WHO. The clinical modifications to the ICD-10 in the USA are known as "US ICD-10 CM".

      Yes, they are very stupid

      However, from an epidemiological standpoint, having better information about the causes of health problems will allow better study of cause and effect relationships between wellness and disease, for example. Even if it is a pain to implement (there must be a code for that).

      How do these codes capture information regarding wellness? Epidemiology is a bastard science anyways. Prediction: A ton of poor people are going to pay more out of pocket because more claims are filed with the wrong code.

    10. Re:U.S. ICD-10 CM not the ICD-10 by Anonymous Coward · · Score: 0

      You might think that, but after having worked on a EMR project myself, this reminds me of the stupidity inherent in the medical field when dealing with data. The data in the database was structured in such a way that everything was a relationship to a table of 'reference data'. There was a service table that would purportedly be an exhaustive list of medical services, a diagnoses table, a drugs table, ... all the way down to a number table. I kid you not, there was a F'in number table, like 1, 2, 3, 4... Everything was supposed to be selected from popups, and thanks to the allknowing join tables, you would only have to pick two or three selections from your popups to have all the other crap auto populated. Needless to say, the design was a complete failure, but it mirrored design approaches I saw in things like these ICD codes as well as the HL7 standards.

    11. Re:U.S. ICD-10 CM not the ICD-10 by Rich0 · · Score: 1

      Agreed - I've seen this sort of thing at work.

      Humans just aren't good at doing table joins, and other things that make perfect sense if you're a programmer.

      You really need to minimize the number of choices a user is presented with at any time - really no more than 10-20 and there can't be any ambiguity between them.

      A hierarchical system is probably going to be better as a result. This way nuanced diagnoses are grouped together so that users can first determine if the person is sick vs dead, and then if a limb was removed or not, and then whether the limb is an arm or a leg, and only at the end you figure out if the pinky finger was removed at the first or second digit.

      Even so, I think this is almost doomed from the start if the goal is to get to this level of granularity. If a guy is shot in the heart do you browse down through heart problems, gunshot wounds, and so on. If somebody died because of some genetic problem that caused them to have a heart attack is that under heart problems, genetic problems, or problems with blood vessels (which caused the heart attack), and so on.

      The only reason that somebody would take the time with the current system to fish through all of that for a more specific code is if it somehow makes a significant difference in their compensation or whether they are compensated at all (which is often the case for a practitioner submitting to an insurance company).

    12. Re:U.S. ICD-10 CM not the ICD-10 by iggymanz · · Score: 1

      means *much* more than copying codes for the developer, adjudication systems have very complicated rule-building systems, claim-filing and office management system also have many things tied to categories. And as patient, that means the number of reasons an insurance company can delay then deny your claim just went exponentially larger. Based on my two decades experience with the industry, I predict a train wreck.

  18. What kind of turtles? by HideyoshiJP · · Score: 0

    I certainly hope this has limitations on what sort of turtles this accounts for. I foresee many claims by the foot clan if not.

  19. TMNT by SJHillman · · Score: 1

    Now does this cover all turtle attacks, or only specific kinds of turtles? Are there subcodes for teenage turtles or mutant turtles or, heaven help us, ninja turtles?

  20. No code for "blogging accident" by ludwigf · · Score: 0

    obligatory

    But there is: Y93D1 - Activity, knitting and crocheting

  21. Edge cases by Arancaytar · · Score: 1

    What if you are attacked at the opera by a trumpet-playing turtle hitting you with a lamp post? What about that shit, huh?

    1. Re:Edge cases by Anonymous Coward · · Score: 0

      I know someone who that exact thing happened to.

    2. Re:Edge cases by Anonymous Coward · · Score: 0

      Then I would suppose you need to lay off the hallucinogenics.

    3. Re:Edge cases by xclr8r · · Score: 1

      Then you are Playing Mario Brothers 24 and should lay off the LSD. (kidding)

      --
      Beware of those who profit off the docile and persecute the unbelievers.
  22. That's just wrong by Anonymous Coward · · Score: 1

    To start with, the ICD-10 codes were not developed by any federal agency, ICD codes are developed by the World Health Organization, part of the UN. The federal government has finally mandated that ICD-10 be used in the United States. The US is the only country still using ICD-9, everyone else has already moved to ICD-10 which was released 12 years ago. The release date of ICD-11 was announced earlier this year, so by forcing the change at least we'll maintain our status of only being one version behind the rest of the world.

    1. Re:That's just wrong by Anonymous Coward · · Score: 0

      To start with, the ICD-10 codes were not developed by any federal agency, ICD codes are developed by the World Health Organization, part of the UN. The federal government has finally mandated that ICD-10 be used in the United States. The US is the only country still using ICD-9, everyone else has already moved to ICD-10 which was released 12 years ago. The release date of ICD-11 was announced earlier this year, so by forcing the change at least we'll maintain our status of only being one version behind the rest of the world.

      But we'll lose our status of being the only one with a sane system.

  23. My favorite, courtesy of NPR by Frequency+Domain · · Score: 1

    NPR did a segment on this yesterday. The best code was "Burned: skis on fire while water-skiing."

    If you've ever seen what a snapping turtle can do to a broomstick handle, the code for a turtle attack wouldn't surprise you in the least.

    1. Re:My favorite, courtesy of NPR by Reverand+Dave · · Score: 1

      I don't know about you, but I for one am glad that someone is finally going to be holding those Macaws to account. Those bastards have had it too easy for too long.

      --
      I got here through a series of tubes
    2. Re:My favorite, courtesy of NPR by JustSomeProgrammer · · Score: 1

      There are separate codes for bitten by turtle and struck by turtle. And three for each. One time for first meeting with the turtle, then one for when he beats you up when you come for payback, and finally one for when that mean old turtle just won't leave you alone.

      Obviously those struck by turtle codes were made because the foot clan gets beaten up too often.

    3. Re:My favorite, courtesy of NPR by Cajun+Hell · · Score: 1

      If you've ever seen what a snapping turtle can do to a broomstick handle

      One of the things that I have recently learned about turtles, is that they are most often seen whenever people are sweeping. If I were a turtle hunter, I would use an audio track of sweeping and an iron bar disguised as a broom, as bait.

      --
      "Believe me!" -- Donald Trump
    4. Re:My favorite, courtesy of NPR by Anonymous Coward · · Score: 0

      I was going to say this. Where I grew up, every pond has a big grandadda snapping turtle in it.

      Every young boy has an urge to fuck with such a creature.

      Or, a common site is a frustrated guy on a sideroad waiting for it to cross, trying to give it a shove.

  24. Is there one for... by Mike+Mentalist · · Score: 1

    If a pig walks by Castle Dracula on a Tuesday playing a banjo, what code is used if you get killed because Dracula bit you?

    --
    I put my books on Amazon, Smashwords, Demonoid, ISOHunt and Pirate Bay. Search for 'Michael Cargill'
  25. Relevant by stubob · · Score: 2

    One of my favorites is T63.192A: "Toxic effect of venom of other reptiles, intentional self-harm, initial encounter"

    But, as silly as these seem, there are already codes to cover the category in ICD-9. The turtle attack correlates to "Other specified injury caused by animal" excluding dogs, rats, snakes and lizards, etc. Similarly, "Accidents occurring in music hall" comes from the existing code "Accidents occurring in public building". So calm down with the government overreaching attitude that I'm sure will prevail in this thread. Being able to say "Other contact with turtle, initial encounter" versus "Other contact with turtle, subsequent encounter" may seem unnecessary, but to medical coders, it's not.

    --
    Planning to be moderated ± 1: Bad Pun.
    1. Re:Relevant by NewWorldDan · · Score: 1

      I know a medical coder and she thinks this is dumb. Most of her co-workers make enough mistakes trying to code to ICD-9. Trying to create a category for everything just means that coding will be slower with more mistakes. Never mind that the doctors and nurses frequently don't include all of the information that ICD-10 expects.

    2. Re:Relevant by Synesthes · · Score: 1

      I do medical coding myself, and I can tell you that she's right on the money. ICD-9 covers basically everything that's needed already. There's really no need to break it down into ridiculous categorization. They say that it'll be useful for reporting, but I think the opposite. When you've got 140,000 codes, it'll be impossible to run meaningful reports. And she's right about the mistakes too. The doctors I know are the most stubborn people you can imagine. You think they are going to wade through 140k codes for the most accurate? Not likely.

  26. Our doctors will lie for us by OhHellWithIt · · Score: 1

    It will be interesting to see whether the codes are used. They're intended to provide useful data granularity, but even the current codes are underused. The psychologists I have worked with all used a diagnosis of something like "non-specific mood disorder" to protect patient privacy rather than giving the insurance company a more specific code with details that might possibly leak back to the patient's boss in some way.

    --
    "Who controls the past controls the future. Who controls the present controls the past." -- George Orwell
  27. I'd like to comment and point out an error by limbodog · · Score: 1

    The law is not creating any codes. ICD-10 codes were created back in the early 90s and have been in use by countries other than the USA since the late 90s. But Medicare hasn't been eager to adopt anything that would require they change their software, so the USA sat on it's butt with the ICD-9 codes for the duration. ICD-10 does indeed give lots more detail. And while some of it is ridiculous sounding, the vast majority provides levels of detail that the insurers have been wanting, but the health care providers have had no mechanism to send. (bear in mind that the HIPAA law requires almost all providers use EDI electronic commerce for sending health care claims, so they've been on a standardized format for years) ICD-9 isn't up to the task. ICD-10 goes above and beyond. There will definitely be some issues (I'm seeing them already on some of my projects at an insurance company) as we figure out how to process claims when we receive a lamp-post-injury code etc. But we'll get there. As for costs. Will it increase costs? Yeah, in the short term. But it's got to happen. We're paying more now for not having it, we'll have to pay a bit more to adopt it, and then it is to be hoped that having it (ICD-10, that is) will eventually reduce some costs. How? Because the claims that get denied because the person shouldn't have been covered that is successfully communicated by the ICD-10 codes means that everyone else doesn't have to pick up the tab for that person who is setting his skiis on fire while being attacked by a bird with a lamp post. Trust me, you want payments to be as accurate as possible.

  28. CODE F8181 by psnINsplPL · · Score: 0

    I'm not joking. F8181: Disorder of written expression

    Y93C1: Activity, computer keyboarding.

  29. Not uncommon by slimjim8094 · · Score: 1

    My EMS agency uses EMSCharts, and it's the same deal. Since they don't allow you to type in a MOI (mechanism of injury), they need to have pretty much anything you can imagine - including several due to injury by spacecraft, depending on whether it was on the launch pad, falling from the sky, exploding, or being worked on.

    Not surprising, it's just what happens when you try to pigeonhole every possible way that people injure themselves. They're too damn creative.

    --
    I have developed a truly marvelous proof of this comment, which this signature is too narrow to contain.
  30. Faceted classification by count0 · · Score: 1

    You're right - a faceted system would be much more powerful (think the guided navigation at your favorite ecommerce store with choices to narrow search by brand, price range, star rating, and type of gear - each of those is a facet).

    It's just math - a system with five facets with 10 choices in each facet gives 100,000 unique descriptions vs. having to write out hundreds of thousands of possibilities.

    For these healthcare codes, looking at facets like type of injury, location of injury, the activity involved, the object involved (turtle or otherwise) etc. would give far better coverage with less complexity.

    cz

    1. Re:Faceted classification by Bob+the+Super+Hamste · · Score: 1

      your forget this system was developed by bureaucrats not engineers so they want to create a comprehensive list instead of a set of choices that will give them complete coverage. I have done similar things with customers, they deliver a comprehensive list of statuses of a system that is a tome when a short set of attributes and values and how to compute each final status is what is what was actually implemented. Not only is this more elegant but can allow for a much more flexible system and they are now shocked at how easy it is to configure something if they found out that their original comprehensive list was wrong or incomplete. It just makes for an over more robust system.

      --
      Time to offend someone
  31. Snapping Turtles by wbav · · Score: 1

    People don't understand how fast a snapping turtle can move, how far it can stretch out or the biting force.

    They assume all turtles are harmless, that is until they are bit by one. Just some stats, they can whip their head around quickly, extend it approximately 75% the length of their body and can snap a broom stick in half with their bite.

    --

    =================
    Unix is very user friendly, it's just picky about who its friends are.
    1. Re:Snapping Turtles by Registered+Coward+v2 · · Score: 1

      People don't understand how fast a snapping turtle can move, how far it can stretch out or the biting force. They assume all turtles are harmless, that is until they are bit by one. Just some stats, they can whip their head around quickly, extend it approximately 75% the length of their body and can snap a broom stick in half with their bite.

      True. When I was younger, we would occasionally catch them; the problem was not so much the catching but the "what do we do now?"

      --
      I'm a consultant - I convert gibberish into cash-flow.
    2. Re:Snapping Turtles by Hatta · · Score: 1

      Turtle soup.

      --
      Give me Classic Slashdot or give me death!
    3. Re:Snapping Turtles by Bob+the+Super+Hamste · · Score: 1

      When I was younger, we would occasionally catch them; the problem was not so much the catching but the "what do we do now?"

      Our solution was usually to club them over the head with the canoe paddle or boat oar.

      --
      Time to offend someone
  32. Alright, hear me out on this... by PseudoCoder · · Score: 1

    I'll be the ridiculous poster who has an actual encounter with a turtle. Getting tossed about by the waves two weekends ago in Maryland, I feel sharp pain and scratching at my shins. There were no trees or branches anywhere on the beach, so I think maybe it's a crab (it is Maryland after all). As I kick to get away from the object, I feel more nipping at my ankles. My crab theory is shot to hell as I see the brown shell about 16" in diameter surface a few feet in front of me. I feel ridiculous as I tell the story when my friends ask me about the blood streaming from my shins and ankle. Had this "attack" been any worse. I may have needed this code after all. (I duck and take cover as I see clumps of vitriol and ridicule coming my way already...)

    --
    "Now, I doubt any of you would prefer a rolled up newspaper as a weapon against a dictator or a criminal intruder."
    1. Re:Alright, hear me out on this... by HTH+NE1 · · Score: 1

      (I duck and take cover as I see clumps of vitriol and ridicule coming my way already...)

      Vitriol can be quite nutritious depending on its preparation. Ridicule can have adverse side effects and interactions and should only be taken under prescription.

      --
      Oh, say does that Star-Spangled Banner entwine / The myrtle of Venus with Bacchus's vine?
    2. Re:Alright, hear me out on this... by orgelspieler · · Score: 1

      Ridicule can have adverse side effects

      Luckily there's an ICD-10 code for that.

  33. This is actually a good thing... by damn_registrars · · Score: 2, Informative

    While people are beating themselves silly to denounce this as "nanny state" or "government take-over of your life", they are missing how this is useful.

    This actually makes health care data more usable. They are setting in a standard ontology for records. It improves comparability across different parts of the country or parts of the population.

    To take the turtle example, previously if you were interested in turtle accidents, you may have needed to look under "reptile" "turtle" "tortoise" or maybe even just "animal". For that matter some people call snapping turtles just "snappers", which of course is also a kind of fish. Now with standard coding it is easier to find quickly who is being hurt by turtles, how often, when, and where.

    --
    Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
    1. Re:This is actually a good thing... by Anonymous Coward · · Score: 0

      which leads to the next question - who gives a shit?

    2. Re:This is actually a good thing... by tbannist · · Score: 1

      It also allows for easy translation into the doctor's native language, though I suppose that's not a feature most Americans would care about much.

      --
      Fanatically anti-fanatical
    3. Re:This is actually a good thing... by asylumx · · Score: 1

      You'd think a website for nerds with a ton of computer scientists would appreciate someone attempting to normalize such a large set of data in order to help keep it clean. I can't even get my users to spell "Infrastructure" correctly, let alone expect them to enter 140,000 different kinds of injury correctly.

    4. Re:This is actually a good thing... by Anonymous Coward · · Score: 0

      Now with standard coding it is easier to find quickly who is being hurt by turtles, how often, when, and where.

      Who Cares?!?!

      Is there some kind of turtle attack epidemic that we need to be concerned with? You seem to neglect the COST of implementing this coding system, while at the same time trying to show a sliver of value (which I think has absolutely ZERO value).

      This entire coding system is ridiculous, will in now way help reduce costs, and will likely only INCREASE costs even more.

    5. Re:This is actually a good thing... by tazan · · Score: 2

      The first issue is they've gone to a level of detail where there are an infinite number of possible reasons, but they only have 140,000 different code. Sometimes there will be a code that fits exactly. It seems more likely though that there will be several that are close but nothing exactly right. Secondly the chances of finding the exactly correct code out of 140,000 codes in a reasonable length of time seems pretty small. And finally the person entering the data most likely does not care how accurate it is, they just want to get something entered and move on. They aren't going to spend 5 minutes looking for a code. In theory the resulting data would be very useful for someone I'm sure. In practice I suspect it will be the opposite.

    6. Re:This is actually a good thing... by Anonymous Coward · · Score: 0

      It also makes healthcare data more prone to mistakes by selecting the wrong code. Or, has people skipping specific codes in favor of generic codes because the weight of the coding system overwhelms the users. Using the turtle example, at what point is the whole thing statistically meaningless, particularly for the very large organizations that claim they need this data for analytics?

      What I'm mostly disappointed to see is how it also shows some political process at work in the coding system definition. Of what use is "opera house" as a location code? What is the need to distinguish this particular entertainment venue from other specific venue types? Does anyone even know how to distinguish an "opera house" from a "movie house" from a "theater" from a "showplace"? Who feels the need to segment out statistics about "opera houses"? The union representatives for opera house workers, or the senator from the district containing the American Association of Opera House Operators? I even wonder if the turtle example is really about justifying the need to reduce the menace of turtles (as commonly reported by the Association of Sport Turtle Hunters).

      There's no doubt that ICD-10 is a superior coding system to ICD-9, but the American extensions are an exercise in academics run wild in some areas and I hope the complexity doesn't go down a compromise path of everyone just using "unspecified" codes.

    7. Re:This is actually a good thing... by cstacy · · Score: 1

      This actually makes health care data more usable. They are setting in a standard ontology for records.

      "Ontology". Isn't that about cancer?

    8. Re:This is actually a good thing... by Skidborg · · Score: 1

      If there was a turtle attack epidemic, how would we know?

      If the medical staff are given a worthwhile code search engine like we have here for purely entertainment purposes will it take them more than a few moments to find the actual code they need? It it really much harder to search through a database of a hundred thousand than twenty thousand? Just type in "fracture, left ulna", look through the short list of results, and you're good to go.

      --
      Supporter of the +1 Over Dramatic mod option. In memory of apk.
    9. Re:This is actually a good thing... by Tony+Isaac · · Score: 2

      The usefulness of the data depends on its accuracy.

      Part of my job is to write software that assists medical coders in selecting ICD-9 codes. Even with ICD-9, medical coders constantly use incorrect codes because nobody can absorb or know all of the possible distinctions. ICD-10 may be more precise, but that doesn't mean coders will KNOW about the new, more precise codes. They already often turn to a more generic code, rather than a more precise one, because they know the generic version already. So increased precision does not necessarily lead to better--or more useful--data.

    10. Re:This is actually a good thing... by Skidborg · · Score: 1

      Trouble finding the right thing in a huge database in a reasonable amount of time? I think I might have a tool for you, though it's rare outside of a few small nerd circles: It's called a search engine.

      --
      Supporter of the +1 Over Dramatic mod option. In memory of apk.
    11. Re:This is actually a good thing... by damn_registrars · · Score: 1

      This actually makes health care data more usable. They are setting in a standard ontology for records.

      "Ontology". Isn't that about cancer?

      No, that is oncology.

      --
      Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
    12. Re:This is actually a good thing... by damn_registrars · · Score: 1

      You'd think a website for nerds with a ton of computer scientists would appreciate someone attempting to normalize such a large set of data in order to help keep it clean.

      You're thinking of the slashdot that used to exist, or today exists only in dreams and memories. Sure, nerds and CSci geeks used to come here to talk about technology. Now, slashdot is just another place for conservatives to come and rant about how much they hate the government, peppered with a few suckers like myself who hope against hope that there could be some useful news buried in this site.

      I can't even get my users to spell "Infrastructure" correctly, let alone expect them to enter 140,000 different kinds of injury correctly.

      I'm pretty sure most record entry would be done through a menu-driven system, so spelling wouldn't matter. For example if a patient was bitten by a turtle, the provider might start under "laceration" then "animal bite" then "non-human", "non-mammal", until they reach "turtle". They would have another menu to select the body part, and other menus to designate when, where, etc. The idea is to take what could be a large degree of variability as a result of human interaction and make it consistent.

      Of course in the end, because this is the USA we are talking about, your insurance company will use it to take more money from you. But the idea does have positive potential applications.

      --
      Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
    13. Re:This is actually a good thing... by Anonymous Coward · · Score: 0

      To take the turtle example, previously if you were interested in turtle accidents, you may have needed to look under "reptile" "turtle" "tortoise" or maybe even just "animal".

      Don't forget "ninja".

    14. Re:This is actually a good thing... by KRL · · Score: 1

      In other words... it could be used for good. Educating a specific population to be more careful about their turtle encounters. OTOH... it will probably just be used for evil.

    15. Re:This is actually a good thing... by Anonymous Coward · · Score: 1

      You are completely clueless. I am a physician at a hospital and I have to take 15 minutes to fill out the codes for every patient after treatment. We hire another group of employees to further refine that in case something was missed or otherwise doesn't match with other visits. There is another group that follows up and audits the codes and payments for compliance with insurance, governments etc.. Another department determines treatment protocol based on the codes---observation, telemetry or "you go home". The new codes are going to raise costs and labor and further destroy healthcare; at least in the USA. The idea is good, the real-world application insane.

    16. Re:This is actually a good thing... by Peter+Simpson · · Score: 1

      If you happen to have an encounter with a shark or a stingray, perhaps. But if your injury was caused by a piranha or, $DEITY forbid, a candiru, it's either a code W5651XA - "Bitten by other fish, initial encounter" or a code W5659XA - "Other contact with other fish, initial encounter".

      Likewise, inline or non-inline skates are options, but kiteboarding isn't even a choice.

      Stay safe...

    17. Re:This is actually a good thing... by Anonymous Coward · · Score: 0

      I agree, but what doesn't get a lot of press is that this is a closed source ontology. In order to use it in your application you need to purchase licenses. It can cost easily $50k for a software vendor to use these codes in their application. That is peanuts if you are a major vendor, but it really hurts if you are a start up or you are solving a problem for non-profit medical clinics where there isn't much cash flow to start with.

    18. Re:This is actually a good thing... by sjames · · Score: 1

      It would be fine except that it drives up the administrative cost of healthcare. Medical billing is already so overcomplex that it requires special training. Imagine if the plumber had to hire a specially trained billing expert to know what the code is for removing Thomas the tank engine (wooden with lead free paint finish) from a toilet!

      Just dump it all into a search engine along with a thesaurus and be done with it.

    19. Re:This is actually a good thing... by scamper_22 · · Score: 1

      This all comes down to your grand assumption that more data will improve care.

      There is a grand belief... and I use the world belief on purpose... that bureaucrats and experts can you use data to run things better. To allocate resources better.

      For example, could you get better care from a general doctor running his/her own office without any complex codes or anything?

      It's the equivalent of eating out at a small family restaurant. They probably don't keep track of huge data sets... but they provide a pretty good meal at a pretty decent price. They also don't have to employ analysts and data collection, and spend half their time filling out complex forms... they provide the service directly.

      Now this is not to say the non-data based businesses perform better. Quite the contrary.

      There are many cases where being data focused helps your business.

      However, I'd prefer that be left up to the society at large to keep things in check. If one medical provider wants to use massive data sets... let them. If another wants to have more personal non-data care... let them.

      In general, this attitude that 'more data' is always better is ridiculous. Do you think you would be any more productive at work, if you had to keep data on everything you did? Every time you started a build logged? Every bug detailed and classified into 100000 categories of bugs? Every coffee break logged?

      I'd actually say this is less than useful. It is going to be counter productive and make medical care worse.

    20. Re:This is actually a good thing... by damn_registrars · · Score: 1

      Hmm. Someone shows up at slashdot claiming to be a physician and can't resist spouting off the classic lines of "raise costs" "destroy healthcare", and of course the boogeyman of "labor".

      What a surprise. Another random troll on slashdot.

      --
      Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
    21. Re:This is actually a good thing... by Anonymous Coward · · Score: 0

      We - are - doomed

    22. Re:This is actually a good thing... by Rich0 · · Score: 1

      To take the turtle example, previously if you were interested in turtle accidents, you may have needed to look under "reptile" "turtle" "tortoise" or maybe even just "animal". For that matter some people call snapping turtles just "snappers", which of course is also a kind of fish. Now with standard coding it is easier to find quickly who is being hurt by turtles, how often, when, and where.

      No, you still have to search for all that other stuff, because why would a doctor's office classify a problem as a turtle accident when they could just capture it as a "bite wound?" Or better still something even more generic.

      I've seen more than a few ICD codes on billing forms and such. A typical office just has half a page of billing codes and the secretary just checks off the one that is closest. Now, if the insurance company would pay them $1k to fix a turtle bite but only $200 for a generic bite wound, then they might take the time to classify it (assuming they even realized the code is available and they treat enough turtle bites for it to be worth their time to check).

      People approach these kinds of problems like a programmer, and they really need to stop and see how people really use these systems. If you want a practitioner to hunt through 140k codes then you need to give them some incentive to do so. Otherwise they'll pick the most generic term that gets them the money they want so that they can send in the form and get back to treating patients.

    23. Re:This is actually a good thing... by Anonymous Coward · · Score: 0

      We are paving the way for computer diagnosis of an injury. Although a human doctor can only remember the most common codes, an intelligent medical scanner could use a standard process to determine the type of injury. Let's build that Tricorder.

    24. Re:This is actually a good thing... by Anonymous Coward · · Score: 0

      Don't assume that, with 140,000 options to choose from, that people will get the right one every time. Don't assume that they will get it right very often. Many people will grab the first one that is close rather than spend extra time in careful consideration. The accuracy of the result will be skewed somewhat. If you are in a hurry, and nobody is watching over your shoulder, do you care how well the industry is served?

  34. Here's a good one. by MadKeithV · · Score: 1

    T124.1.17.ZZ.Plural-Z.Alpha: Intentional self-harm injury sustained to left head in booth 24 at Eccentrica Gallumbits Spa and Saunas, hit in the head with a gold brick wrapped in a slice of lemon.

  35. Generic code for a bunch of them by bongey · · Score: 1

    ID 10 T injury.

  36. 1990 by Anonymous Coward · · Score: 1

    Hello year 2011!! This is 1990 calling, we want our news back!

    ICD-10 was endorsed by the Forty-third World Health Assembly in May 1990. Who would have thought that Americans were going to take soo long to get with the program.

  37. Don't be so sure you can do better by Cajun+Hell · · Score: 1
    When I rewrote everything, I was delighted that my ICD1 code list (since it was a totally new instance, I got to restart all internal version number sequences) contained only one entry:

    1. living->hit() got called

    and hit() just took a hit_points argument. I felt pretty clever.

    I was surprised that everyone hated it. It turned out they wanted different damage types, so that magic missiles could bypass armor, some kinds of monsters could be resistant to fireballs, and so on. So I added a second optional parameter (which, if not passed, defaulted to blunt force trauma) for damage type. Then there was a list of defined constants for the damage type. It started out a short list

    DAMAGE_BLUNT=0;
    DAMAGE_SLASH=1;
    DAMAGE_FIRE=2;
    DAMAGE_COLD=3;
    DAMAGE_ELECTRICITY=4;
    DAMAGE_PUNCTURE=5;
    DAMAGE_RADIATION=6;
    DAMAGE_FLESH_EATING_SYNDROME=7;
    DAMAGE_PUNCTURE_SILVER=8;
    DAMAGE_TURTLE=9;
    DAMAGE_POISON=10;
    DAMAGE_BLUNT_SILVER=11;
    DAMAGE_SLASH_SILVER=12;
    DAMAGE_POISON_BLOOD=13;
    DAMAGE_POISON_NERVE=14;

    (Around the time we added werewolves, I realized I should have used an enum.) But people kept adding new things. Now that list of constant is up to 140000 entries. You can't ever really fix the problem, so please give our federal agencies some slack.

    --
    "Believe me!" -- Donald Trump
    1. Re:Don't be so sure you can do better by Anonymous Coward · · Score: 0

      What IS the ICD-10 code for being bitten by a werewolf?

    2. Re:Don't be so sure you can do better by Cajun+Hell · · Score: 1

      We just use DAMAGE_TURTLE for most bite wounds because they're all about the same. This isn't ideal but seemed like a good compromise at the time. And the lycanthropy disease transmission is handled separately.

      Yeah, it's turned into kind of a kludge, which is why I'm rewriting everything again. No more damage type constants defined in the code. It'll be a database key.

      Nothing can possibly go wrong this time.

      --
      "Believe me!" -- Donald Trump
  38. "From the government"?? by count0 · · Score: 2

    Exactly how to you talk to the government? Are you talking with policy experts? Politicians? Government healthcare researchers? Government funded healthcare workers? In what capacity? What jurisdiction? What department?

    I know that for most people, government is government is government. That's cool - government is at its best when it just takes care of things so well you don't notice it (rare but possible).

    But if you're going to make a claim that the government intentionally plans for a 2-3 year period where hospital care is nearly impossible to get (and as a result thousands of people die) then you need to have a little more specificity than "I've heard from the government".

    Something you may have heard from the health policy side: With the demographic curve of aging boomers, Western healthcare systems will have to become incredibly efficient in the next couple decades to keep the same level of care (older people need more care, we have more older people...). If we don't get those efficiencies, then we will likely see a period where hospital care is more difficult to get because of those increased pressures on the system.

  39. Turtle and Macaw, but no Lion or Bear? by Maury+Markowitz · · Score: 1

    Try it yourself. Think of something really dangerous, like skydiving... nope. Parachute? Nope. Cougar? Nada. Macaw? You bet!

    1. Re:Turtle and Macaw, but no Lion or Bear? by dccase · · Score: 1

      Parachutist is there, however.

      And cat-scratch disease.

    2. Re:Turtle and Macaw, but no Lion or Bear? by orgelspieler · · Score: 1

      Also, all industrial machinery is lumped into one category. As if a lathe and a drill press are equally likely to cause the same sorts of injuries. There really doesn't seem to be any rhyme or reason to why the insurance companies want this particular level of granularity.

  40. Turtle-Related injuries by Anonymous Coward · · Score: 0

    Y87D6 - Attacked by turtle
    Y87D7 - Stepped on turtle, foot injury
    Y87D8 - Assaulted by nunchuck-wielding turtle
    Y87D9 - Knuckles scraped while apprehending law-breaking turtle
    Y87D10 - Sexually harassed by turtle
    Y87D11 - Back injury while lifting heavy turtle
    Y87D12 - Fingers mashed while setting down heavy turtle
    Y87D13 - Dementia caused by hypno-turtle
    Y87D14 - Arm sprain from throwing turtle to friend
    Y87D15 - Hip injury caused by slipping on turtle used as base in game of pick-up softball
    Y87D16 - Tongue bitten off by turtle
    Y87D17 - Lips bitten off by turtle
    Y87D18 - Phobia of having face injured by turtle
    Y87D19 - Sore butt from riding turtle
    Y87D20 - Hand lacerations caused by using turtle as rope to help friend (or enemy) up a cliff
    Y87D21 - Back trauma from being trampled by herd of turtles
    Y87D22 - Failed implantation of turtle shell into back to look like TMNT
    Y87D23 - Turtle impact on head
    Y87D24 - Repetitive injury to index fingers, left ring finger, and right ring finger from typing "Turtle" over and over again
    Y87D25 - Full-body abrasions from filling ball pit with turtles and then diving into it
    Y87D26 - Sore throat from yelling at turtle while trying to train it
    Y87D27 - Deafness from trying to use turtle as hearing aid
    Y87D28 - Hit in back by thrown turtle
    Y87D29 - Misc. Turtle injury

  41. ICD-10 is not "New" by DiabolicallyRandom · · Score: 2

    ICD-10 has existed since the 80's - it is not "new", and it was not created by the laws, however it was modified heavily for the version (CM being implemented) ( Work on ICD-10 began in 1983 and was completed in 1992. - http://en.wikipedia.org/wiki/ICD-10 / Draft Revisions were finished on ICD-10-CM in 2003 - http://en.wikipedia.org/wiki/ICD-CM ) The laws have, however, mandated its implementation in the US by October 1, 2013 (preceded by HIPAA5010 no later than 01/01/2012), and with good reason I might add. Its just a flying shame it has taken this long to get around to being mandated - it was originally slated to be implemented by October 1, 2010 - but the healthcare lobby didn't want to spend all the money up-front to adapt, and so they delayed it.

    For those implementing it, it is a major PITA - but in the end it will result in better, more efficient medical billing and information exchange. This is a Good Thing (TM) - It should go a long way to help avoid things like this: http://science.slashdot.org/story/09/08/26/2316210/VA-Mistakenly-Tells-Vets-They-Have-Fatal-Illness

    For clarification, ICD-10 proper has been in use in the US already for some time, since 1999, but only for mortality reporting, not billing/procedure detail, etc.

    Full Disclosure: I work for a major regional health carrier on adopting full HIPAA 5010 and ICD-10/ICD-10-CM support.

    1. Re:ICD-10 is not "New" by Dan667 · · Score: 1

      not a good thing. More bureaucracy for no benefit except for private health care to manipulate it to make more money.

    2. Re:ICD-10 is not "New" by DiabolicallyRandom · · Score: 1

      It is obvious you did not read the article I linked as an example. Just like any tool, it can certainly be misused - however, having highly specific and detailed diagnosis codes can prevent serious, even potentially life-threatening mistakes from happening.

      Just because its being mandated for "billing", does not mean the same codes aren't used for a myriad of other things, from patient communication, to history checks before treatment.

      I am not trying to put some rose colored glasses on everyone and imply that some, if not most insurance companies will do Bad Things, especially those who are out to earn profit and beholden to their shareholders. But at the same time, one should not paint this change with such a broad stroke so as to imply it is globally bad.

      FWIW, most health insurance companies were against ICD10 adoption, due to the cost of implementation, and the fact they could no longer deny claims in certain cases due to enhanced detail. That is why it's adoption was delayed.

  42. other contact with a turtle? by Nadaka · · Score: 1

    Code W5929XA, W5929XD, W5929XS are for other contact with a turtle...

    Does that include STD's?

  43. S01412A, S01112A, S61412A by kiehlster · · Score: 1

    Laceration without foreign body of left cheek and temporomandibular area, initial encounter; Laceration without foreign body of left eyelid and periocular area, initial encounter; Laceration without foreign body of left hand, initial encounter;... I mean, *face palm*.

    1. Re:S01412A, S01112A, S61412A by Bucky24 · · Score: 1

      I dunno about you, but when I face palm I don't do it so hard as to cause lacerations... You should think about cutting your fingernails.

      --
      All the world's a CPU, and all the men and women merely AI agents
  44. burn due to water-skis on fire by Jeremy+Erwin · · Score: 1

    Probably
    W34: Discharge from other and unspecified firearms
    or
    X95: Assault by other and unspecified firearm discharge

    1. Re:burn due to water-skis on fire by Jeremy+Erwin · · Score: 1

      Oops. Those are codes associated with potato guns.

      "Burn due to water skis on fire" is a natural consequence of the fact that
      a. Boats sometimes collide with each other, causing accidents.
      b. Marine fires can be very dangerous.
      c. Waterskis are a type of watercraft.

      Codes can be combined to give an epidemiologist some idea of what happened, and as with most codes, unlikely combinations can occur.

      It's no different than observing that English words are made up individual letters, so theoretically, "Xyzzy" could mean something.

    2. Re:burn due to water-skis on fire by Muad'Dave · · Score: 1

      ... theoretically, "Xyzzy" could mean something.

      It already does.

      --
      Tiller's Rule: Never use a word in written form that you've only heard and never read. You will end up looking foolish.
    3. Re:burn due to water-skis on fire by Jeremy+Erwin · · Score: 1

      whoosh.

    4. Re:burn due to water-skis on fire by Muad'Dave · · Score: 1

      Whoosh on you. Clearly he didn't choose that out of thin air.

      --
      Tiller's Rule: Never use a word in written form that you've only heard and never read. You will end up looking foolish.
  45. Finally! by AioKits · · Score: 1

    Now The Shredder gets a code for all the work related turtle injuries he's had to endure!

    --
    "Quote me as saying I was mis-quoted." -Groucho Marx
  46. broken by Anonymous Coward · · Score: 0

    The fact that we have an entire profession (Medical Coding and Billing) dedicated just to the billing practices for something (medical care) is a sign that the system is hopelessly broken.

  47. Keeps me employed by Anonymous Coward · · Score: 0

    I write software for the medical industry. Keep 'em coming.

  48. why are amateurs designing this ontology? by markhahn · · Score: 1

    an enumeration has got to be the stupidiest, least usable, most 1950's card-deck kind of approach imaginable.

    not that other people (say, librarians or linguists) do a better job. but isn't this really the case where people with no computer experience are effectively designing programs? people with computer/applied-math backgrounds could make this work right.

  49. Beaver Attacks? by Caradoc · · Score: 1

    So what's the code indicating "nipple bitten off by a beaver?"

    --
    Specialization is for insects. - R.A.H.
    1. Re:Beaver Attacks? by Anomalyst · · Score: 1

      So what's the code indicating "nipple bitten off by a beaver?"

      Better yet: beaver licked by a paramour?

      --
      There is no right to feel safe thru security vaudeville at the expense of everyone's freedom, privacy and tax money.
    2. Re:Beaver Attacks? by Qzukk · · Score: 1

      S21.059 (Open bite of unspecified breast (since you didn't say left or right)) + W53.81XA (Bitten by other rodent, initial encounter)

      The complete list of the current american version (ICD-10-CM, 2011 edition) can be downloaded from the CDC. The hierarchical organization that makes it possible to answer your question is fairly well explained at the wiki page here. Injury (Sxx) -> Thorax (S2x) -> Superficial injury (S20) etc. Causes of Injury (Vxx-Xxx) -> Unintentional act of living creature (W5x) -> Rodent (W53) etc. Unfortunately wikipedia uses the 2007 WHO website version of ICD-10, and doesn't go into as much detail as the ICD-10-CM guide published by the CDC does.

      --
      If I have been able to see further than others, it is because I bought a pair of binoculars.
    3. Re:Beaver Attacks? by Caradoc · · Score: 1

      I take it you don't ever watch Jeff Foxworthy...

      --
      Specialization is for insects. - R.A.H.
  50. These codes can be useful by Anonymous Coward · · Score: 0

    As someone who's used these codes (for an evil insurance company, boo!), they're usually used to isolate types of common injuries and improve safety/processes in that area.
    It's far better from an ins. perspective for a claim to never happen vs. trying to deny it or anything (Lawyers be expensive, yo). Also, I don't think these are used in coveraging decisions, just for statistical separation. In some cases, the difference between a slip/trip/fall on the same level vs. with something on the floor vs. due to another outside influence could mean major differences in how you update the work place.

    I imagine these codes were generated from a tagging system, but I can guarantee switching to that sort of system vs. a new list of codes would be $$$$$$$$$$$$$$$$$$$$$$

  51. One big number? Is there an app for that? by Animats · · Score: 1

    The medical billing people have this obsession with "codes", because they're designing for paper-based systems. This sort of info ought to be collected with something where someone clicks on a body outline to show where the injuries are, and then there's additional info for "how serious" and "source of injury". For the last part, it's probably only worth collecting info for the top 20 or so causes (autos, guns, falls, etc.) Allow for a narrative description for unusual cases, and send those to a call center for detailed coding.

    1. Re:One big number? Is there an app for that? by brusk · · Score: 1

      That would be one possible way to drill down to appropriate codes, but this system is designed to be used anywhere in the world, including places where hospitals don't have computers, and was devised in 1990. So that's a bit much to expect.

      --
      .sig withheld by request
    2. Re:One big number? Is there an app for that? by Animats · · Score: 1

      That would be one possible way to drill down to appropriate codes, but this system is designed to be used anywhere in the world, including places where hospitals don't have computers, and was devised in 1990. So that's a bit much to expect.

      Not really. It's only needed where there's an insurance reimbursement system in use that requires detailed tracking of what's being done for each patient. If the bureaucracy is in place for that, there will be computers available.

    3. Re:One big number? Is there an app for that? by chiguy · · Score: 1

      This is sort of how it works.

      S00–T98 Injury, poisoning and certain other consequences of external causes
      S90–S99 ankle and foot
      S92 Fracture of foot, except ankle
      S92.4 Fracture of great toe

      For unusual cases, it'd be something like: S92.9 Fracture of foot, unspecified
      in which case a progress note would have to be sent to the insurer.

      --
      passetspike!
    4. Re:One big number? Is there an app for that? by Chitlenz · · Score: 1

      Exactly! The whole of the coding system actually uses Vocabularies to determines the state (such as mood codes) of the patient so that the actual coding can be scoped down to represent informed use. Concepts (CUI) lead to atomic use (AUI) based on the context of the patient or subject (entity) so that by a subject symantic type you can translate the actions within a patient encounter to a VERY granular level. Consequently, regarding the top level post, it's not that people are obsessed with coding, its that its the process which drives the billing cycle in pretty much every hospital, and every insurance company, and has for over 20 years. The UMLS used to drive me nuts, until I realized that it makes more sense when you start from the HL7-RIM (Reference Info Model) first and work down from there to give the framework coherence.

      --
      Imagination is the silver lining of Intelligence.
    5. Re:One big number? Is there an app for that? by Rich0 · · Score: 1

      Should the system used to drive insurance billing in a national-scale health system in the first world be based on a design that has to first start with the assumption that the user might be in Zimbabwe and could not afford a computer?

    6. Re:One big number? Is there an app for that? by brusk · · Score: 1

      The system was devised by the World Health Organization for use worldwide. So yeah, it should.

      --
      .sig withheld by request
    7. Re:One big number? Is there an app for that? by brusk · · Score: 1

      Actually the system would still be useful for public health data even where there is no insurance system as such (e.g., under a nationalized health scheme or in military hospitals where all medical services are covered by the state and no third party is billed).

      --
      .sig withheld by request
    8. Re:One big number? Is there an app for that? by Rich0 · · Score: 1

      Then whoever develops the systems used for any kind of national healthcare system should create something better. Doctors in Zimbabwe can use codes from a 1960s-era mainframe if they want to.

      Vast quantities of money get spent on the present ICD9 system, and in most cases people just work-around all the complexity by using a handful of more generic codes anyway.

  52. You know by bob8766 · · Score: 1

    This is all time that could have been spent making a healthcare system that doesn't suck

  53. What are the chances... by Anonymous Coward · · Score: 0

    Hmmm ... 140,000 codes to classify medical issues... Now, what are the chances that the person at the Hospital who has to enter the correct code for your particular condition is going to accurately classify your condition into one out of 140,000 possible categories? No human being is going to be able to know all 140,000 codes. So people are going to have to use some sort of search/indexing scheme to try to find the correct code. What are the chances that someone will fail to put in just the right terms in your case that will actually find the correct code?

    This is just plain silly. All that is going to happen is that cases that should have been filed under the same code are going to end up under different codes because of the limitations of the person doing the data entry. In the end, it will be meaningless.

  54. Will be abused by Anonymous Coward · · Score: 0

    The powerful turtle lobbyists in Washington will abuse this data to expand the power and influence they have on turtle based legislation. I predict legalization of turtle marriage (and gay turtle marriage) in a few short years unless this is stopped.

  55. Spacecraft??? Really? by Muad'Dave · · Score: 1

    Spacecraft: http://graphicsweb.wsj.com/documents/MEDICALCODES0911/#term=spacecraft
    Nuclear Weapons: http://graphicsweb.wsj.com/documents/MEDICALCODES0911/#term=nuclear+weapon
    3 pages of alcohol: http://graphicsweb.wsj.com/documents/MEDICALCODES0911/#term=alcohol including "Blood alcohol level of 240 mg/100 ml or more"
    Primary Thunderclap Headache??? : http://graphicsweb.wsj.com/documents/MEDICALCODES0911/#term=clap
    Contact with hot toaster (as opposed to being hit over the head with a cold toaster, I aasume): http://graphicsweb.wsj.com/documents/MEDICALCODES0911/#term=toast

    "War operations involving destruction of aircraft due to accidental detonation of onboard munitions and explosives, civilian, subsequent encounter"
    "Sexual harassment on the job"

    The mind boggles...

    --
    Tiller's Rule: Never use a word in written form that you've only heard and never read. You will end up looking foolish.
    1. Re:Spacecraft??? Really? by Jeremy+Erwin · · Score: 1

      Contact with hot toaster (as opposed to being hit over the head with a cold toaster, I assume)

      One involves burns, while the other does not.

  56. structure? or just a list? by bityz · · Score: 1

    Does anyone know if it is just a flat list? Or is it an OWL-DL ontology? Or something else?

  57. Huge assumption by ThatsNotPudding · · Score: 1

    that the undoubtedly overworked, underpaid staffers tasked to 'fill in the blanks' have the time to look up such minutiae.

  58. I found the best one by way2trivial · · Score: 1

    Y92146
    Swimming-pool of prison as the place of occurrence of the external cause

    how many swimming pools in prisons anyway?

    --
    every day http://en.wikipedia.org/wiki/Special:Random
  59. DFF by Deadstick · · Score: 1

    Years ago I read an account by a British Army officer of his days leading a band of native guerrillas in attacks on the Japanese in Burma. They got all their supplies by airdrop, and had to grab the stuff and beat feet in a hurry because the airdrop would alert the enemy. Once in a while a man would be injured trying to catch a package, and one man was killed by a crate of canned pineapples.

    He invented a new cause code for deaths and injuries in his logs: DFF, for Death by Flying Fruit.

    rj

  60. Maybe it's a tribute? by aaribaud · · Score: 1

    What he wanted to say was this: Was sailing SSW at position 33 degrees N 72 degrees W. First mate, who you may recall was appointed in New Guinea against my wishes and is probably a head-hunter, indicated by signs that something was amiss. It appears that quite a vast expanse of seabed has risen up in the night. It contains a large number of buildings, many of which appear pyramid-like in structure. We are aground in the courtyard of one of these. There are some rather unpleasant statues. Amiable old men in long robes and diving helmets have come aboard the ship and are mingling happily with the passengers, who think we organized this. Please advise.

    His questing finger moved slowly down the page, and stopped. Good old International Maritime Codes. They'd been devised eighty years before, but the men in those days had really thought hard about the kind of perils that might possibly be encountered on the deep. He picked up his pen and wrote down: "XXXV QVVX." Translated, it meant: "Have found Lost Continent of Atlantis. High Priest just won quoits contest."


    in Good Omens, by Neil Gaiman & Terry Pratchett.

  61. Not as dumb as you'd think by Anonymous Coward · · Score: 0

    I live in central New York, and we have TONS of snapping turtles that migrate all over the place toward the latter part of spring and into early summer. If you get too close, they are easily capable of taking a finger off.

    In a world where people willingly stick fireworks in their anus, turtle injury seems much more mundane.

  62. They need to be even more accurate... by Anonymous Coward · · Score: 0

    ...about government contract billing codes, as well as government employee timesheets.

  63. Rule 34 subset by PPH · · Score: 1

    Might be interesting reading. Particularly the object X lodged in orifice Y subgroup. Or RSI injuries.

    --
    Have gnu, will travel.
  64. So Few Codes by Anonymous Coward · · Score: 0

    It's very sad, and telling, that our government recognizes fewer than 140,000 different species.

  65. Can't find it... by Anonymous Coward · · Score: 0

    Citation needed.... can't find it in the list

    1. Re:Can't find it... by Alsee · · Score: 1

      Citation needed.... can't find it in the list

      The Wikipedia code tables are rather incomplete. icd10madeeasy.com appears to have complete listings.

      Under the old ICD9 system:
      V692 High-risk sexual behavr

      Under the new ICD10 system:
      Z725 High risk sexual behavior
      Z7251 High risk heterosexual behavior
      Z7252 High risk homosexual behavior
      Z7253 High risk bisexual behavior

      -

      --
      - - You can't take something off the Internet! That's like trying to take pee out of a swimming pool.
  66. No Hamster related injuries listed! by SloWave · · Score: 1

    Are we really getting our tax dollars worth with this new upgrade? There seems to be nothing related to hamsters there.

    1. Re:No Hamster related injuries listed! by Chitlenz · · Score: 1

      Cough... SNOMED-CT - 242609008 - Bite of hamster (event) :) PS - There were actually several more observable events involving hamsters, and a total description string count of 210 involving 'Hamsters'. So, I guess you have to say "yes", its worth the money?

      --
      Imagination is the silver lining of Intelligence.
  67. Cleopatra syndrome by Anonymous Coward · · Score: 0

    T63082A Toxic effect of venom of other African and Asian snake, intentional self-harm, initial encounter

  68. costs? by elliott666 · · Score: 1

    Wow, I wonder how health care got to expensive in this country. Oh wait, that's how. Every penny spent on this was a waste.

  69. Everybody's missing a source of profit by Quila · · Score: 1

    1.5: Invest the premiums in various financial vehicles

    For example, Cigna had a net income of 1.3 billion last year, helped out by a net investment income of 1.1 billion.

  70. New law? Foolish headline. by Anonymous Coward · · Score: 0

    This law has been on the books for years now. The fact that we are (again) approaching the deadline for the switchover doesn't make the law new.

  71. It all makes sense by Xarin · · Score: 1

    It all makes sense once one understands the coding scheme:

    V91.07XS

    The first three characters are the type of water transport accident that caused the injury:

    V90 Drowning and submersion due to accident to watercraft
    V91 Other injury due to accident to watercraft
    V92 Drowning and submersion due to accident on board watercraft, without accident to watercraft
    V93 Other injury due to accident on board watercraft, without accident to watercraft
    V94 Other and unspecified water transport accidents

    Next there is a sub-code that further categorizes the incident:

    V91.0 - Burn due to watercraft on fire
    V91.1 - Crushed between watercraft and other watercraft or other object due to collision
    V91.2 - Fall due to collision between watercraft and other watercraft or other object ...

    After that is a code that identifies the type of water craft:

    0 - Merchant ship
    1 - Passenger ship
    2 - Fishing boat
    3 - Other powered watercraft
    4 - Sailboat
    5 - Canoe or kayak
    6 - Inflatable craft (nonpowered)
    7 - Water-skis
    8 - Other unpowered watercraft
    9 - Unspecified watercraft

    And then the following 2 character code:

    XA - Initial Encounter
    XD - Subsequent Encounter
    XS - Sequela

    One can then combine what is needed in a systematic way. The confusion comes when they are blindly enumerated to generate every possible combination. Some combinations will not make sense but that is just a side affect of not specifying the water craft and encounter type individually for every sub-code. For instance 'water-skis' is perfectly reasonable for other sub-codes such as:

    V91.2 - Fall due to collision between watercraft and other watercraft or other object

  72. So, will people start lying to their doctor? by Yakasha · · Score: 1
    Seriously. With these more exact codes saying things like :
    • V9107XA Burn due to water-skis on fire, initial encounter
    • V9107XD Burn due to water-skis on fire, subsequent encounter
    • V9107XS Burn due to water-skis on fire, sequela

    How long do you think its going to take the insurance companies to start raising rates for "stupid" people? At which point people will start lying to their doctors to avoid increased premiums (or just the embarrassment), thus reducing the effectiveness of care, increasing the duration of care, and probably increasing costs.

    I don't think Insurance companies need to know how people are injured or become sick.

    1. Re:So, will people start lying to their doctor? by bws111 · · Score: 1

      As the poster above you pointed out, no-one expects those codes to be used. They are simply an enumeration of codes and sub-codes, some of which don't make sense when put together. Did you ever play Mad Libs? It is kind of like that. Give me a random injury (burn) and random place where injury occurred (on water skis) and a catastrophe (fire). Yes, it is funny when you put them together, but it is not something normally done. However, there is nothing funny about 'Burn due to passenger ship on fire'.

      I am not sure, but I don't think that the 'initial encounter' stuff means an initial encounter with water skis on fire, I think it means an initial encounter with the DOCTOR for that injury (vs a followup or chronic condition).

      As for insurance companies needing to know that information: I agree that in most cases they don't need to know the information for a specific case (although there may be exceptions like auto accident and workplace accident that should be paid for by auto insurance or workmans comp). However, the aggregate of that information can be very valuable to insurers. For instance, if they see a significant number of injuries due to water skis on fire, they can start pushing for better fire suppression on water skis (yes, stupid example, but it is the one everyone is using). I know it is very popular on slashdot to say that the insurance companies only want to deny claims, but they would much rather not have the claims to deny in the first place. Ever wonder why Underwriter's Laboratories (UL) has that name?

  73. Big datasets are fun :) by Chitlenz · · Score: 1

    We do this, specifically I program and design PACS (Radiology) and EMR systems that use various coded sets. What's really interesting about the "water skis" thing people caught on NPR is that in reality there are 61 specific codes involving 'skis' alone, and that's just in English. Within the full subset of the Metathesaurus we use, there are in excess of 4M interacting concepts, and with the entire set there are over 400M interacting concepts. To make things even more complex, CPT, ICD-10, SNOMED-CT, and others all have to be made relational such that an injury related to "water skis on fire" has subrelational codes for the skis (material), what the patient was doing (observational), and what a role (doctor) does about it (procedural) before it can be billed to insurance, a process that (even electronically) takes up to 30 days and 20 revised submissions. This is PER BILLING STATEMENT. You have to be a special kind of warped to get into this (I, for instance, started as a DBA...). All this said, the whole of the codesets actually can describe pretty much anything in reality, starting with the semantics of the subject and trickling down to the price of each material and service consumed. It's pretty complex, but it's truly challenging, and beats the hell out of coding drudgery based projects by a long shot.

    --
    Imagination is the silver lining of Intelligence.
  74. What about beaver attacks? by Anonymous Coward · · Score: 0

    As in the tale relayed to Rachael Ray by Jeff Foxworthy ( see http://www.youtube.com/watch?v=NKzIJBCkJ2M ) what is the code for having a nipple bitten off by a beaver?

  75. Aeschylus by tgeek · · Score: 1

    Supposedly the ancient Greek poet Aeschylus was killed by a tortoise dropped from a great height, so maybe that one's not so far-fetched. NB: the summary says "attacked BY a turtle", however the actual article includes the codes for "attacked WITH a turtle" - quite a difference - especially to a certain ancient Greek poet . . . the creepy ones are for "Other contact with a turtle". I dare not even speculate on what that "Other contact" might be . . .

  76. Do they have... by Darinbob · · Score: 1

    Do they have a code for Nerd Rage?

    1. Re:Do they have... by BurstElement · · Score: 1

      Do they have a code for Nerd Rage?

      That would be F99

  77. Don't you just hate it when... by BurstElement · · Score: 1

    You've run out of coffee! T43616A Underdosing of caffeine, initial encounter T43616D Underdosing of caffeine, subsequent encounter T43616S Underdosing of caffeine, sequela

  78. They thought of everything by Anonymous Coward · · Score: 0

    V9543XA - Spacecraft collision injuring occupant, initial encounter
    V9542XA - Forced landing of spacecraft injuring occupant, initial encounter
    V9540XA - Unspecified spacecraft accident injuring occupant, initial encounter

    Well, not quite everything. I could not find codes for:

    * Autoerotic asphyxiation
    * Anything to do with nanotechnology
    * Hovercraft

    I assume IDC-11 is already being drafted, however.

  79. Aquatic rabbits by Anonymous Coward · · Score: 0

    Is there a code for being attacked by aquatic rabbits?

  80. Why do they need to be so precise? by jonwil · · Score: 1

    For example, if someone breaks their leg, why does it matter if the leg was broken by a fall from a ladder, someone beating them up and stealing their wallet, a turtle bite, stepping on a land mine or whatever else?

    A broken leg is a broken leg and the only thing that should matter is which leg is broken, how badly broken it is and what the correct treatment for that particular broken leg is.

  81. There's a code for that - not by scdeimos · · Score: 1
    For some reason there's no code for "Struck by toilet seat fallen from ISS." Toilet seat codes only include:
    • W1811XA, Fall from or off toilet without subsequent striking against object, initial encounter
    • W1811XD, Fall from or off toilet without subsequent striking against object, subsequent encounter
    • W1811XS, Fall from or off toilet without subsequent striking against object, sequela
    • W1812XA, Fall from or off toilet with subsequent striking against object, initial encounter
    • W1812XD, Fall from or off toilet with subsequent striking against object, subsequent encounter
    • W1812XS, Fall from or off toilet with subsequent striking against object, sequela
  82. Turtles? Srsly? by Anonymous Coward · · Score: 0

    Does that cover attacks by teenage mutant ninja turtles too?

  83. What's my code by Anonymous Coward · · Score: 0

    I strained a groin muscle while reading slashdot. Can somebody give me the code for that one?

  84. Not 140,00 Injury Codes by Anonymous Coward · · Score: 0

    Just to be clear... these 140,000 codes aren't just the injury codes, that is the number of ALL diagnosis codes. They are just expanding to more specificity. US is one of the LAST to implement these universal codes.

    Now if we could just get our physicians to document properly (greatest specificity) so guidelines aren't broken...

    BTW, this will produce more IT jobs (just sayin).

  85. Mario Bros. by Anonymous Coward · · Score: 0

    Now Mario can claims correctly!

  86. What about "Struck by Fire Hydrant" by Anonymous Coward · · Score: 0

    This list is obviously insufficient. My son, when he was 5, was jumping off of a fire hydrant, and struck his forehead on the top of the fireplug. He needed multiple stitches to seal the bleeding. I guess this committee just doesn't know the problems related to getting struck by a fire hydrant.