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Tuesday, September 13, 2011

Classifying Stupid or "Stupid Gone Wild"

ICD-10 - No better example.
(Side Note: "Everyone is asked to wear Steelers attire to the funeral." A friend passed away recently.  This above quote was the last line of the obituary.  We will miss you.)


Medical billing is going to be taking a large leap into the future very soon.  And yes, all those ads for "medical billing from home" will no doubt see a spike.

Today about there are about 18,000 standardized medical codes describe medical procedures for billing - I guess mostly for government systems like Medicare and Medicaid.  The system is called the International Classification of Disease or ICD-10.

Unfortunately for all of us this system of codes is going to expand from 18,000 codes to almost 140,000 codes over the next couple of years - hold on to your wallets!

In the new version we see things like (in case you don't believe me see this):

W22.02XA, "walked into lamppost, initial encounter"

W22.02XD, "walked into lamppost, subsequent encounter"

It goes on - encounters with furniture, multiple air bag strikes from the same side (W22.12xD, "Striking against or struck by front passenger side automobile airbag, subsequent encounter"), nearly every kind of ball (W21.02xA - "Struck by soccer ball, initial encounter"), and so on, oh my God!

I suppose W22.12xD is used when what, the airbag in your car goes off twice?  Sadly airbags are on designed to go off once.  Or perhaps you've been slammed into the airbag more than once by multiple impacts to the car? 

I wonder if parts of the door still clinging to the airbag count for another code?

According to this WSJ article there are codes for injury by sewing, ironing, playing a brass instrument, crocheting, doing handcrafts, or knitting as well.  Isn't knitting a handcraft?

In the V91 series we find V91.07XA, "burn due to water-skis on fire."

And how about V91.04xA,"Burn due to sailboat on fire, initial encounter."

Or V93.22xA, "Heat exposure on board fishing boat, initial encounter" as compared to V93.24xA, "Heat exposure on board sailboat, initial encounter."  And finally there's V93.23xA, "Heat exposure on board other powered watercraft, initial encounter."

What if I am fishing from my sail boat?  What if my sailboat has a motor?

Will my "heat exposure" be somehow different?

Perhaps only for insurance purposes...

There are more series of codes specifying "pedestrian" injuries with skateboards, roller skates, and so on - but nothing for roller blades per se.

While we might want to laugh about this you can bet your wallet that its going to dramatically increase the cost of healthcare - in fact it is already.

Massive amounts of training are required so someone can divine meaning from this manifest stupidity.  Every one from medical billers to hospital IT to government agencies will be affected.

New expensive channels of communication will need to be built between doctors, healthcare facilities and insurance companies to ensure that little Johnny's heat stroke was properly obtained on a sailboat as opposed to a powered water craft - though there will be problems if there is a motor on that sailboat.

Insurance companies will rewrite policies to restrict coverage further with this new knowledge: we don't cover carple tunnel for brass players.

The title itself is a lie: International Classification of Disease?  Heat stroke on a sail boat is a disease?  Airbag impact a disease? 

No... as I've said before: Any sufficiently (stupid, asinine, idiotic, moronic, foolish, lazy, ...) act is indistinguishable from pure evil.

This to me seems to fit the bill of evil.  The cost of implementation alone would probably cover decades of meals on wheels for seniors in some state.

Are we that much better off knowing that someone got sunburned on a sailboat as opposed to a fishing boat?

I don't think so.

This is stupidity gone wild.  Sure people do stupid things - their people - people are stupid.  So rather than fight stupidity we create a system to classify it.

And imagine the possibility once this system becomes part of everyday life.

Fines for injuries, which should normally be accidents and not crimes, could now focus on the fact that the injuror was wearing skates as opposed to riding a skate board when colliding with the injurie. The officer at the scene will be able to use his tablet computer to find the right code and tack on an additional $50 fine for skate board as opposed to skates.

The home owners policy for little Johnny on the skate board will prohibit coverage in case of collisions so Daddy and Mommy will have to fork over the cash themselves and pay the fine.

No, I am afraid this is all about money.

If you think for one minute that this has to do with healthcare you are a fool.  This will be used to make your medical life an order of ten (18,000 codes to 140,000 codes - nearly a factor of ten) more confusing, stupid and insane.

Your doctor not up to speed on the new codes?  Payment delay - and guess who will get dinged for the bill?

Hospital computer system not up to speed?  Bingo! A ten thousand page bill to you to cover the difference until its all straightened out.

Of course this is all not without a controversial element as well.  Consider the various "F" codes which cover various mental illnesses along with transgender issues.

No, the ICD-10 is merely good government in action:

"No one will be happy. Everyone will pay.  More government jobs!"

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