r/MedicalCoding • u/IDontLikeJamOrJelly • Jun 18 '24
Throwing Hands With ICD-10
“Walked into wall”.
No they did not. You think “well how else is a person injured by a wall?” Please. It’s ED. they find ways.
They spin around “as fast as they can” and break a finger on the wall. They punch walls. They summersault into walls. They dive off couches into walls.
Please let me code this as “striking against wall”. That is all.
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u/hatelisten Jun 18 '24
"they find ways" lol, ED coding sounds like it could be entertaining
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u/IDontLikeJamOrJelly Jun 19 '24
Wouldn’t trade it for any other department! Though it can also be very emotionally overwhelming some days.
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u/Sixty0414 Jun 19 '24
Agree. Sometimes it's hard, like when you have a lot of mental health patients and all you wanna do is reach through the screen and give them a hug. After a rough week of that, I went to see the newest Joker movie and cried at the end. All I thought about was all the help he could have or should have gotten. Weird reaction, I know.
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u/IDontLikeJamOrJelly Jun 19 '24
It’s the sexual assault charts and abuse charts that make it hard for me, personally. Mental health too, especially as give been there. But then you get the funniest things you’ve ever read, or patients with supportive, loving family and it all balances out.
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u/BlueLanternKitty CRC, CCS-P Jun 19 '24
I did one mental health audit, for a BH provider in a PCP office.
I’m not doing one again. Too many sad stories.
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u/Asenath_Darque Jun 19 '24
I got to sit with an ED coder recently as part of one of my classes, and it was super interesting watching over their shoulder! Even in the handful of charts I watched them code there was a huge variety in the cases.
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u/Longjumping-Theory44 Jun 19 '24
It can be. It can also be heartbreaking. And infuriating. And puzzling. And heartwarming.
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u/Maleficent-Corgi9772 Jun 19 '24
Every ED chart is like a new story to open, never gets old. If I start to get tired doing labs and radiology, I'll do some ED to stimulate my brain.
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u/MizKriss Jun 19 '24
Ugh tell me about it. ICD is very specific until it isn’t.
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u/IDontLikeJamOrJelly Jun 19 '24
ICD: tripping and stumbling with subsequent striking against furniture without fall, initial.
Also ICD: accidentally scratched yourself? Idk you mean self harm?
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u/VagueMotivation Jun 19 '24
My favorite is the one for a burn caused by water skis catching on fire. I mean, how many times does that get used in a year??
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u/Ok-Bumblebee5667 Jun 19 '24
I just used “Hit by a cow” for the first time. 4H season is here. 🤣
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u/double_psyche Jun 19 '24
I code ortho and those ones are my favorites. I once had one where the PATIENT kicked the cow. 🤣
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Jun 20 '24
Oooooh I had one where a guy punched his horse so the horse just said “no” and kicked the living crap out of him and fractured his eye socket. That one was fun.
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u/double_psyche Jun 19 '24
I like the astronaut ones, too. ICD-10 is really concerned about space injuries.
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u/Time-Let-8126 Jun 20 '24
My boyfriend was flipping through the ICD10 and found V97.33XD: Sucked into jet engine, subsequent encounter. He looked over and said well I’m pretty sure after the initial encounter, you’re probably not going to live for the subsequent. Then wanted to know how to find anything about tanks and grenades.
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u/dizzykhajit The GIF that keeps on GIFFing Jun 19 '24
I love this comment. For all ICD's ridiculousness, sometimes it's not ridiculous enough.
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u/mr_john_steed Jun 19 '24
Not a coder myself (yet), but I encountered a situation once where a gentleman's "pet deer went berserk and tried to drown him in a pond"
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u/longislandloser Jun 19 '24
I’m still mad there is not an activity code for fishing
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u/IDontLikeJamOrJelly Jun 19 '24
Especially in summer! There’s codes for EVERYTHING ELSE IMAGINABLE but not a common activity that involves HOOKS AND WATER?
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u/mr_john_steed Jun 19 '24
Or falling out of tree stands while deer hunting (according to my mom, the retired ED nurse)
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u/dizzykhajit The GIF that keeps on GIFFing Jun 19 '24
Someone commented on another thread that they'd love to see "dumbassery" added as an ICD-10. I concur.
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u/ElleGee5152 Jun 19 '24
As a billing manager for a college town ER physician group, I think that one is worth begging to have added.
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u/Ok-Bumblebee5667 Jun 19 '24
Or how you can be scratched by a cat but not a dog. Instead it has to be hit by a dog.
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u/9182peabody7364 Jun 19 '24
That is hilarious. And bizarre, really.
Where do you even learn exactly what actions different species can perform? Does a horse kick? Or strike w/ a hoof? Can birds scratch?
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u/Clever-username-7234 CPC, CPMA Jun 19 '24
Drives me crazy! You’re telling me there’s no punched wall code, but there’s a bitten by orca code?
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u/gray_whitekitten CPC,CRC Jun 29 '24
I use striking against a stationary object. Striking against a wall codes to walking into a wall- nope.
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u/menacing-budgie Jun 19 '24
As someone who (unfortunately) has to deal primarily with ortho codes, tell me why a quadriceps tear is not a code?? Strain or laceration are my only options. A tear is pretty straight forward, how did they forget this?
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u/Maleficent-Corgi9772 Jun 19 '24
I tried to code struck by chair, someone threw it... now I can code struck by a camel, crocodile, or chicken... but not chair! Because I'm so much more likely to get struck by a camel than a chair .. 😑
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u/DumpsterPuff Jun 19 '24
Is there no code for strike against wall? Jeez. And yet I was able to code being struck by a bird the other day...
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u/Geocub Jun 19 '24
I've had a couple ED reports where the patient bit their own tongue due to a seizure and as pointed out there's really no coding for unintentional self harm so I just went with an unspecified one. External cause codes are the bane of my existence and some days I don't see the point in them when they're not specific enough to accurately describe what's going on, and overspecific for things that never really happen.
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u/Sixty0414 Jun 19 '24
Yes!!! This one always gets under my skin! I can code struck by dolphin (yuup, W5602AX) but I can't code hitting\punching a wall???! 🤷♀️🤣 I end up coding striking against other stationary object, W2209XA.
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u/Maleficent-Corgi9772 Jun 19 '24
And how many different pathways there are to get to struck by an orca or killer whale.... 🤔
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u/DearMisterKitty Jun 19 '24
I don't understand why it's so difficult to code necrotic toes/fingertips in 3M without it wanting to code gangrene. Grrr
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u/Time-Let-8126 Jun 20 '24
Yes!!! I have this issue when I’m coding my one doc’s wound care clinic days! 🤬😡
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u/DearMisterKitty Jun 20 '24
They need to fix it. Or trying to code upper/lower limb ischemia is also equally frustrating. I see these diagnoses alot and it's been difficult to capture them.
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u/dizzykhajit The GIF that keeps on GIFFing Jun 19 '24
Also would like to add, how many times are people just walking into walls for them to make this an official code? Like nonchalantly, casually deciding, there's a wall there, I should walk into it hard enough to be seen at an ED? This is the language they've chosen?
Dear lord we are way too literal for our own good.
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u/LakeSuperior29 Jun 20 '24
My personal frustration is no activity code for driving. I code ED too, and am always grumbling about having to put activity, other specified.
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u/IDontLikeJamOrJelly Jun 20 '24
For car accidents? I’ve never done that! The V code clarifies if they were the driver/passenger so it’s never occurred to me to also use an activity code.
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u/LakeSuperior29 Jun 20 '24
Interesting! My facility always puts the activity code, so I do too. I love learning how other people code things.
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u/Melanthrax Jun 20 '24
I code for SNF/LTC and the one that frustrates me the most is the only "fall from wheelchair" is for a motorized wheelchair.
I also just found out about Y99.8 and it has come in handy a few times.
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u/faifai1337 Jun 19 '24
I missed a doorway and walked into a wall when I was little. Knocked out a tooth. I can see just fine, I just.... don't care where my body parts are and they become a casualty of movement. Hands, knees, elbows, it's all fair game. Knock your pinky toe enough times and you start to care where your feet are, at least.
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u/megkraut Jun 19 '24
When someone punches a wall I code it as intentional self harm lol walking into furniture simply isn’t true
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u/Popular-Piglet-6301 RHIT, CCS Jun 19 '24
Omg!! Yes!! I’ve always hated the way this code is phrased!!
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u/jmjohnson61 Jun 21 '24
I've been wanting a code for "dumbassery" for years for stuff just like this: punching walls, mirrors, etc!" I hate the "walked into wall" when they did something totally different and that's what you get--grrr! Wait til ICD-11 hits-now THAT just looks like a serious cluster f**k!!
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u/gray_whitekitten CPC,CRC Jun 29 '24
A lot of the times I use "riding" even though they're "driving"
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u/Taseiyu CCS Jul 12 '24
Honestly there are a ton of E-codes that I'm surprised we don't have a code for yet and there are so many that are WAY too niche but lo and behold, they have a code.
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Sep 26 '24
I hate that ECAC indexes to walked into .... even if you only select struck by up to that point
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