ICD-10 was a major overhaul of the ICD-9 system.

 ICD-10 was a major overhaul of the ICD-9 system. The codes were changed dramatically. For this discussion, go to the following website: http://www.icd10data.com/ICD10CM/Codes. Scroll down and click on the code section of V00-Y99 External Causes of Morbidity. After reviewing the various coding possibilities, in your initial post, discuss your reactions to the number of options. Were you surprised by the number of options? Can you think of anything that was not already covered by the codes? Choose one code option and provide a brief description of when it would be appropriate to assign it to a patient encounter. In your follow up posts to peers, do you agree with their assignment of the code to the patient encounter? Support your reasoning.

REPLY TO MY CLASSMATE’S DISCUSSION TO THE ABOVE QUESTION AND EXPLAIN WHY YOU AGREE. (MINIMUM OF 200 WORDS)

                                                       CLASSMATE’S POST

According to Chapter 20 (External Cause of Morbidity) in ICD-10-CM, there are over 7500 codes. The number of codes is much larger than I imagined and provides many options for coding just about any possible condition. I thought perhaps there would be about 1,000 codes, but every incident/accident appears to be covered by the V00-Y99 code section.

The Centers for Disease Control (CDC) describes these codes as codes that provide additional information such as how the injury occurred, the intent where it took place, and the patient’s status at the time of the injury. It is also reported that there is no national requirement for mandatory reporting of these codes, but this information should be reported.

As I searched the codes, I don’t think I saw injuries related to elder abuse such as willfully withholding medical attention and food resulting in starvation. There is a category for Assault X92-Y09, injuries inflicted by another person with the intent to injure or kill by any means. I know of a case where the family withheld medical attention and food from a family member until the elderly person died. 

ICD-10-CM Diagnosis Code Y74.3, surgical instruments, materials, and general hospital and person-use devices associated with adverse incidents. Other codes that could be applicable include Y81.3 and Y81.8, surgical instruments, materials, and general-and plastic surgery devices associated with adverse incidents, not elsewhere classified.

The code option I reviewed: Misadventures to patients during surgical and medical care Y62-Y69.   Type 1 Excludes surgical and medical procedures as the cause of abnormal reaction of the patient, without mention of misadventure at the time of the procedure, (Y83-Y84). Other codes that may be applicable include:  W45.8XXA for retained sponges during surgery/foreign body or object entering through skin or retainment of foreign body fragments Z18-Z18.0 ICD-10 CM Code.

The above codes represent examples whereby surgeons leave sponges or other foreign objects in patients during surgery.  I recently was speaking to a nurse colleague that introduced me to a surgeon who was said to be notorious for leaving sponges in patients. It was said he is on staff at several hospitals and works a lot. Such complications or injuries result from retained sponges and surgical instruments. Such comprises patient safety and can have catastrophic implications for patients. 

                                                                           References:

World Journey of Surgery (2011). Retained Surgical Items and Minimally Invasive Surgery.  Retrieved from: www.ncbi.nlm.nih.gov/pmc/articles/PMC3140941 

UHDDS (2015). Uniform Hospital Discharge Data Set: UHDDS. Retrieved from: http://medicalbillingcodingworld.com/2015/07/uniform-hospital-discharge-data-set-uhdds/

Industry News (2016).  Medical Coding Tips. Retrieved from: https://www.hiacode.com/topics/codingtips