July 18, 2016

Live Long and Prosper Under ICD-10-CM

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EDITOR’S NOTE: Star Trek Beyond will be released on July 22, 2016. The fourth installment in the rebooted sci-fi series is to begin production on Sept. 26, 2016.

If you are unfamiliar with the Star Trek brand, it began with a TV series in 1966 with William Shatner as Captain Kirk and Leonard Nimoy as Mr. Spock. They traveled the universe with the crew of the starship Enterprise and boldly went where no man has gone before! This beloved series is celebrating its 50th anniversary this year.   

 What does this have to do with ICD-10, you might ask? Recently I was reviewing the 2017 ICD-10-CM codes – all 71,486 of them – and wondered how prepared ICD-10-CM would be to handle space travel. Here are my results:

If a space traveler was to come into contact with some unknown but hazardous substance, Z77.098 (Contact with chemicals (hazardous) (chiefly nonmedicinal)) would be the code.   

If there was some problem with the physical environment, like a planet’s surface being too hot or harboring harmful vegetation, contact with hazards in the physical environment NEC (Z77.128) would be assigned.

Dealing with nuclear energy, a service member of the Enterprise may have contact with uranium, which is coded to Z77.012. A person could also have retained depleted uranium fragments, which would be assigned Z18.01.

Unfortunately, the United States has some experience with dealing with spacecraft disasters, such as the Apollo 1 fire, the Challenger disaster, Apollo 13’s mechanical failure, and the breakup of the Columbia space shuttle upon reentry. The External Cause Index features all types of accidents that involve the occupant of a powered spacecraft. These codes include Collision with any object fixed, moveable, or moving (V95.43XA); Crash (V95.41XA); Explosion (V95.45XA); Fire (V95.44XA); and Forced Landing (V95.42XA).

When a space traveler returns home and has been weightless for a period of time, the problems of the effects of weightlessness may be classified to X52.XXXA. This code includes weightlessness causing injury, the effects, and if the weightlessness was in a real spacecraft or simulated one.

I also found that the place of occurrence was not very specific – Y92.89 (Other specified place of occurrence). If the problems occurred in an airplane, it would be captured as Y92.813. 

Of course, as our space travels advance through the galaxy, they will be exposed to cold (X31.XXXA); heat (X30.XXXA); and perhaps radioactive isotopes (W88.1XXA). I also found it interesting that exposure to nuclear energy is classified under war operations!

There is no activity code for space exploration either. If the astronaut is paid for space duty, then the external cause status code would be Y99.0 (civilian) and Y99.1 (military).

It seems like there are more codes to add to ICD-10-CM when we consider space exploration. Of course, we could be using ICD-11 by the time that becomes more relevant.

Live long and prosper under the current ICD-10-CM code set!
Laurie Johnson, MS, RHIA, CPC-H, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer

Laurie M. Johnson, MS, RHIA, FAHIMA is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an American Health Information Management Association (AHIMA) approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and makes frequent appearances on Talk Ten Tuesdays.

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