Thursday, 1 October 2015

70,000 Codes

If you think about the 1920s.....we probably had around one to two thousand ways that a guy could get sick or die.

This week, we (the US government) wrapped up the ICD-10 codes for hospitals and insurance companies....which tell you the various ways that we can die or get sick.

There are now 70,000 ways to get sick, hurt or get dead.

I paused over this.

One of my long-distant relatives had the misfortune of getting kicked in the head by a mule.  In those days, there was no code.  You just kinda noted his name and important dates on some headstone, and a couple of stories were generated over how it occurred.  The guy's been dead for a hundred years....but I imagine via the least twenty people have some knowledge of the guy.

Do we really need 70,000 codes?  It's hard to say.

It might be shocking to realize that eighty people die each year from bicycle accidents involving training wheels, or six people die each year from elephant attacks in the US.  My brother would probably note that six guys a year from the county die from boating accidents, although you'd need a sub-code to note alcohol in half of these, and lack of a life-preserver in the other three.

Somewhere in this mess.....there's probably a code for death-by-frying-pan, death-by-chimney-collapsing, death-by-angry-wife, and death-by-falling-off-the-roof-while-straightening-the-antenna.

The curious thing will be if we add another 10,000 codes by 2030.

1 comment:

Politics Alabama said...

Okay, I am a software developer with a company, and I work with diagnosis and procedure codes all day, every day. Here's the thing.

The ICD9 code set contained everything needed to describe any injury or illness known at the time... and if any new ones cropped up, there were "unknown" specifiers that could even represent that. What the ICD10 code set adds is specificity, and the ability for bureaucrats to track HOW people are getting injured.

For example, where ICD9 had codes that equated to "moderate bite injury on left hand, forefinger", ICD10 contains all that data THREE TIMES... once for "initial encounter", once for "subsequent encounter", and one for "sequela".

For those not in a medical field, sequela means "an abnormal condition resulting from a previous disease or condition."

Another example is this: ICD9 contains 22 codes for drowning, such as "accidental submersion or drowning in water transport accident, occupant of small boat"... with variations for powered, un-powered, other watercraft, and non-crew. ICD10, on the other hand, has 375 codes for drowning, 30 of which deal with drowning after falling or jumping from a burning watercraft... with variations based upon the type of burning boat! There's merchant ship, passenger ship, sailboat, canoe, kayak, inflatable craft, water-skis, fishing boat, and the ubiquitous "unspecified burning watercraft".

In other words, the new codes basically are for the bean-counters in the CMS statistical department, and not much else. In my opinion, at least.