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Friday, February 28, 2014

The Bureaucratic Hydra


From "When squirrels attack! There’s a medical code for that," a recent article in the Washington Post:
[I]n a beige and windowless hotel ballroom thousands of miles away, hundreds of American medical coders are diligently chipping away at the exact same task. They’ve set out to master the nuances of the sprawling ICD-10, formally known as the Tenth Edition of the International Classification of Diseases.


With 14,000 codes, ICD-9 seems puny by comparison. The new manual explodes that code set to 68,000 much more granular and detailed terms to define — very exactly and specifically — what ails us.


The prospect of quadrupling the number of medical codes used in those calculations has touched off a heated debate over whether more specificity is an onerous layer of bureaucratic red tape — or a valuable chance to better understand and treat complex medical conditions.

The codes in ICD-10 can seem absurd in their granularity, replete with designations for seemingly impossible situations.

There are different numbers for getting struck or bitten by a turkey (W61.42 or W61.43). There are codes for injuries caused by squirrels (W53.21) and getting hit by a motor vehicle while riding an animal (V80.919), spending too much time in a deep-freeze refrigerator (W93.2) and a large toe that has gone unexpectedly missing (Z89.419).


One study funded by the American Medical Association estimated that it could cost doctors’ offices $56,000 to $8 million to transition to ICD-10, depending on the size of the practice. The AMA, one of the larger groups opposed the switch, is still petitioning the federal government to reverse course....
Read it all HERE.

What a nightmare — and coming soon to a medical provider's office near you!

Additional reading (February 2012): "Parrot injuries and other tales from the annals of medical billing."


  1. One of my (many) aunts was an inveterate hypochondriac. She had many good qualities, and like every other member of my mother's side of the family -- even my grandpa! -- was a wonderful cook, BUT she couldn't seem to get through a day -- or at least phone call to one of her sisters -- without coming down with a mysterious ailment she would attribute to whatever Cause of the Day took root in her imagination. She had "Soup Headaches," attacks of Queasiness brought on by Eggs, a Back Pain she was sure was Caused by Eating Too Much Candy in a weak moment, her Hands Trembled if she dared drink even so much as One Cup of Coffee, she often Felt Faint at the prospect of going to the Movies. She resisted getting a television set for years, because she was sure it would give her "The Heebeejeebies." Exactly what The Heebeejeebies were no one could ever figure out, but aunt was certain that all of us were going to suffer with them if we didn't stop this, or start that, etc.

    We all loved her, but everybody in the family ridiculed her behind her back, and made jokes at her expense, because no one believed a word of it. The younger sisters dismissed her as "Neurotic." My uncles just said, "Aw she's crazy -- but harmless. Leave her alone. It's just her way of amusing herself."

    Like everybody ese, she just wanted sympathetic attention, and conjuring up a wide variety of imaginary illnesses were the way her subconscious contrived to get it.

    In many ways our precious government reminds me ore and more of silly old aunt, only the government is neither nice nor funny, and only a fool could imagine it was lovable. As the saying goes today, "It's high time Uncle Sam got over himself."

  2. Oh Boy! There's nothing better than giving a bureaucrat more choices, huh Ducky.

  3. My hubby can tell you the nightmare of these codes, which ultimately ends in hospitals not betting paid. If you happen to use the wrong wording in a diagnosis the hospital will not be paid for their services. There are many words to describe the same thing, just as there are many codes to describe the same thing, use the wrong one and you are working for free.

    Right Truth

    1. Debbie,
      Thank you for sharing that information! Many outside the medical professions have no idea as to those realities.


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