ICD-10 Illustrated
Edited By Niko Skievaski
c.2014, ICD-10 Illustrated, LLC; $20.00
Wisconsin, 72 pages
On April 2, 2014, President Obama signed the Protecting Access to Medicare Act of 2014 (“ACT”). The ACT, which avoided the 24 percent payment reduction in Medicare provider payments triggered by the Sustainable Growth Rate (“SGR”), also delayed implementation of the International Classification of Diseases, 10th Revision, Clinical Modification (“ICD-10-CM”) code set.
Previously, the deadline for implementing the CD-10-CM code set was October 1, 2014. Now, health care providers and suppliers have until October 1, 2015 to prepare for implementation. Throughout the nation, health care providers are breathing a collective sigh of relief coupled with a noted grunt of continuing frustration with respect to implementation of the code set, which was to begin end-to-end testing with Medicare in July. The Centers for Medicare and Medicaid Services (“CMS”) cancelled the end-to-end testing in a MLN Connects Provider Bulletin issued on May 2, 2014, and providers continue to await additional comment from the CMS the delayed implementation and what the delay means with respect to readiness, rescheduling of the end-to-end testing, and expanded opportunities for providers to participate in the limited testing process.
The ICD-10-CM code set code expands the previously used ICD-9 code set exponentially. Providers and suppliers now have approximately 75,000 diagnosis codes to decipher when assessing and treating patients. (The ICD-9 code set utilized approximately 17,000 diagnosis codes). The new diagnosis codes are touted as being more helpful in assisting health care providers in focusing on the location, type, and severity of the patient illness or injury. It is anticipated that the voluminous ICD-10-CM code set will also clarify provider documentation and make the claims submission process easier for both payers and providers - each side now knowing what, when, where, and how regarding the patient’s illness or injury and what treatment was actually furnished by the health care provider.
However, the same reasons, which make the ICD-10-CM code set more helpful, also make the code set humorous. A soft-bound book of illustrations, W56.22, Struck by Orca, highlights some of the more humorous diagnoses hidden within code set. For example, the book includes tasteful artist representations of the following bizarre codes:
V91.07xA, Burn Due to Water Skis on Fire, Subsequent Encounter. Because water is usually non-flammable, the patient’s explanation regarding how the fire initially started should be fully documented in the medical record along with the physician’s recommendation regarding how to avoid additional encounters with flaming water skis in the future.
W22.02xD, Walked in a Lamppost, Subsequent Encounter and W00.01xD, Pedestrian on Foot Injured in Collision with Roller Skater, Subsequent Encounter. After the initial encounters, which may have occurred at Mardi Gras, would not a diagnosis of “intoxication” be more precise?
W56.22xD, Struck by Orca, Subsequent Encounter. This diagnosis along with W56.21xS, Bitten by Orca, sequel; W56.49, Other Contact with Shark; and a whole host of other codes describe odd encounters with marine life. Most probable recommendation from attending health care provider: stay on land.
V97.33xD, Sucked into Jet Engine, Subsequent Encounter. The discharge summary for this patient should include a clear recommendation for the patient to find an alternative mode of transportation.
W95.42xA, Forced Landing of a Spacecraft, Injuring Occupant, Initial Encounter and X52, Prolonged Stay in a Weightless Environment. Just in case we are not alone in the galaxy, and the space aliens are in need of medical treatment.
And my personal favorite, W04.xxxS, Fall while being Carried or Supported by Other Person,
Sequela, and W60.xxxA, Contact with Nonvenomous Plant Thorns and Spines and Sharp leaves, Initial Encounter. These codes document and explain why the Princess, long held captive in a moss and vine-covered tower, arrived in the emergency room with a broken arm and splinters after the Prince’s successful rescue attempt.
The editor, Niko Skievaski, explains that the book is a “collaboration among artists representing a diverse background in healthcare across the United States.” As health care providers continue in their quest to implement the ICD-10-CM code set by the new October 2015 deadline, this book and its artful representations will add laughter to an otherwise stressful transition process. It can also be used as an effective component of the training process. Coding and non-coding professionals alike will definitely find the descriptions interesting and entertaining. I certainly did.
Cynthia Ransburg-Brown, JD, a partner in the Health Care Consulting Group at Sirote & Permutt and avid reader, advises clients on a variety of corporate and regulatory health care law matters.
