Flaming Jet Skis, Spacecraft Crashes, Suicide By Jellyfish… And The Attack Of ICD-10


Seriously, ICD-10 billing codes are coming. Unless you untangle yourself from the red tape of bureaucratically controlled healthcare, you are going to need to adjust to this staggering reform. The common way to deal with corporatocratic upgrades is with the classic seminar — and ICD-10 is no different. Thankfully, The Weekly Standard sent a writer to cover one such seminar… Attendees paid between $585 and $985 for a two-day “boot camp” taught by Annie Boynton, with credentials “longer than the alphabet… BS, RHIT, CPCO, CCS…” Students took their seats and found a thin spiral book​—​the “ICD-10-CD General Code Set Manual” for 2014​—​and a six-pound “ICD-10 Complete Draft Code Set” that was as thick as a phone book…


The looming changes are vast. The number of codes will explode from 17,000 under the current system to 155,000 under the new one, according to the Centers for Medicare and Medicaid Services (CMS). And before we jump to conclusions and point fingers at Obama, keep in mind this overhaul has been planned since before 2010.

Some background: The current coding system, ICD-9, has been in place for almost 30 years. It has gradually expanded. New codes have been added to reflect new diseases, the latest treatment innovations, and technology upgrades. However, proponents claim that it’s bordering on capacity. ICD-10 proponents​ — like Boynton — ​say there’s no choice but to adopt a more sophisticated code set.

About 20 years ago, other developed countries began implementing ICD-10. This came after the World Health Organization released its basic version of the new code set. However, their versions of ICD-10 won’t be nearly as complicated as our U.S. version.

Something to consider: Boynton says that only 10 other countries use the codes for reimbursements​. This is ​one of the main functions of ICD-10 here in the U.S. Also, payment systems are far less complicated in other countries. Love it or hate it, that’s because there’s usually one payer — the government.

The multiplicity of payers in the U.S. system partly explains why ICD-10 will be vastly more complicated here. But, this is great, when the government wants to sell the idea, they explain the “simplicity” of ICD-10 codes. But, when you go to a seminar, they then explain the vast complexity.

“If you sustain an injury falling off a toilet seat on a spaceship in Jacksonville after this class, there’s probably a code for that,” says Boynton.

There are codes for those “bitten” by a crocodile, “struck” by a crocodile, and “crushed” by a crocodile. There is also a code for injuries sustained through “other contact” with crocodiles. “I just don’t want to know about ‘other contact,’ especially with farm animals,” says Boynton, to sustained laughter. “That joke doesn’t fly in Montana.”

Boynton’s “personal favorite” is code V9027XA: “Drowning and submersion due to falling or jumping from burning water-skis, initial encounter.”

Personally, our favorite is T63622A — Toxic effect of contact with other jellyfish, intentional self-harm, initial encounter…