Medical Billing Codes Gone Wild!

Here on the SunTech blog, we normally aim to provide valuable clinical information and helpful tips related to all things blood pressure. But allow me to wax philosophical for a moment, because…well, you’ll see why.

Right. So, for many of us who work in health-care or a health-care related field, there is significant meaning to be found in doing a job that can positively affect people’s well-being. It’s great to wake up every day knowing that you will indirectly or directly help to cure illnesses, heal wounds, save lives, and treat burns due to water skis on fire…wait, huh?

Oh believe me, it’s true. At least, it is according to the soon-to-be-implemented medical diagnosis and inpatient procedure codes—codenamed ICD-10—from the Centers for Medicare & Medicaid Services (CMS). I have to confess that this is one of those times that I’m kind of embarrassed to be associated with the health-care industry. A recent, and quite entertaining, article in the Wall Street Journal* questioned the sanity of going from a system of about 18,000 codes currently in place (ICD-9) to around 140,000 codes in ICD-10, and on the face of it questioning such a change seems more than legitimate.

To be fair, some of the additional details do make some sense, like code G43601: Persistent migraine aura with cerebral infarction, not intractable, with status migrainosus. Such specific detail helps payers and providers analyze and properly allocate resources to provide optimal patient care.  But “W5622XD: Struck by orca, subsequent encounter?” Really? How often do people generally get struck by orcas? And I thought medical billing was already a complicated mess. Sheesh.

Pardon me while I go hide under a rock. Wait…is there an ICD-10 code for being injured by a large, stony protuberance under odd circumstances? Yes, there is! W228XXA: Striking against or struck by other objects, initial encounter. Oh thank goodness!

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