Do We Really Need All These ICD-10 Codes?

turtles-unmarked-01_blog_main_horizontalICD-10 is the coding system for disease, abnormal findings, causes of injury or disease.  This will be the 10th revision of the International Statistical Classification of Disease and Related Health Problems – affectionately shortened to ICD which is put together by the World Health Organization (WHO).  The U.S. ICD-10 will have roughly 68,00 codes and the U.S. also uses a procedure code system not used in any other country that will contain 76,000 codes.  This is already a big jump in the number of codes from ICD-9 codes currently used.  There will need to be much training done and this will make adjuster’s days that much longer looking up all the new codes and formats.

Is there really a need to have all of these codes?  I understand the need for the system but there are many codes that are just very far fetched and not really likely to happen.  Today we wanted to touch on a few codes that are very unlikely to happen, maybe as an adjuster you will need to memorize these, but in the event that you see any of these injuries come through you will have a code to process your claim:

    • Bitten by a turtle – W5921XS (workers comp for a sea world employee?)
    • Burn due to water skis on fire – V9107XA
    • Headache associated with sexual activity – G4482
    • Pedestrian on foot injured in collision with roller skater – V0001XD (I wonder if the coming and going rule could be applied under this one)
    • Hurt at swimming pool of prison as the place of occurrence – Y92146 (I am pretty sure that is one swimming pool I would not want to swim in)
    • Shock due to lightening, subsequent encounter – T7501XD (Either you are very unfortunate or lightening can strike the same place twice)
    • Unspecified event, undetermined intent – Y34 (this could be the most vague code of all, could this open up Pandora’s box?)

These are just a few of the outrageous and bizarre codes that will be featured in the new ICD-10 manual.  To all of our adjusters out there I am sure this will be big change.  I wonder how many of you will see codes and diagnosis that are new to you.  I think that adjusters will need to be as proactive as possible to learn as much as they can.  I think that hospitals and insurers will provide training, but in my opinion you cannot rely on that alone.  It will be interesting to see if there are more reports on fraud and how this change over will affect the workers compensation industry as a whole.


What's your take? Continue the discussion with others over at the WCInsights LinkedIn Group.
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