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Your Monday Morning Mental Sorbet: Enough Health Codes to Choke a Horse (K222)


Each week we try to start you off with something that will stimulate your brain into working–or perhaps numb it into being able to take the work week a little easier. This week…well, not quite sure how you’ll take this one. But here goes.

Apparently by 2013 there’s going to be a shift in the system of how doctors and hospitals code the services they provide. The system in place today uses roughly 18,000 different codes. According to the article in the Wall Street Journal, that number’s jumping to 140,000. Why so many? Because the system is incredibly granular to the point where:

Code V91.07XA, which involves a “burn due to water-skis on fire,” is another mystery [Rhonda Buckholtz, who does ICD-10 training for the American Academy of Professional Coders] ponders: “Is it work-related?” she asks. “Is it a trick skier jumping through hoops of fire? How does it happen?”

[ad#longpost]Reading through the article and their searchable database, one thing immediately struck me. The example code they give of Y92253 for “Opera house as the place of occurrence of the external cause.” Which made me think instantly that the victims of Erik, the Phantom of the Opera, would all be coded thus.

And, naturally, I started to think of other fictional injuries and ailments and how they would be coded. For the purposes of this thought experiment, because I couldn’t find a bloody explanation anywhere, “initial encounter” means the first time you’ve run into the problem. “Subsequent encounter” means a second or later time you’ve run into the problem. And “sequela” isn’t a female sequel, it’s circumstances resulting from something–but not directly that something. If that makes any sense. I might be completely wrong in my estimates of what the terms mean, but seriously, I couldn’t find an explanation to help out.

So, of course, I instantly thought: zombie attack. Well, if you assume that zombies would still be considered as mammals then you get Code W5581XS: “Bitten by other mammals, sequela.”

Hmmm. The injuries John McClane sustains on his bare feet from dealing with broken glass in Die Hard? That would be W25XXXA, W25XXXD and W25XXXS. For “Contact with sharp glass, initial encounter,” as well as subsequent encounter and sequela.

What about Michael Madsen slicing off the dude’s ear in Reservoir Dogs? S08111A: Complete traumatic amputation of right ear, initial encounter.

Indeed, what about the injuries sustained during the fights inside mobile homes in both Raising Arizona and Kill Bill? That would be codes Y92020 through Y92029.

What about the evil world-beater that Howard the Duck defeated in that movie nobody likes to think about? W6169XA: Other contact with duck, initial encounter.

And the alien that Will Smith “welcomes” to Earth in Independence Day? V9542XA: Forced landing of spacecraft injuring occupant, initial encounter. No lie–they have codes for spacecraft.

It never ends. You could give a code to The Elephant Man of R461: Bizarre personal appearance. Leonardo DiCaprio and Jack Nicholson both have had characters who succumbed to T68XXXA: Hypothermia, initial encounter.

The one I was surprised I couldn’t find? Luke Skywalker getting his hand lopped off in Empire Strikes Back. Amazingly, I could not find a code for getting your hand amputated while in an air shaft. I guess the system has still got a few holes in it.

Want to have fun with this? The searchable database is online here. Leave us your favorite fictional character injury/trauma/ailment and the resulting code in the comments.


  • T63312A Toxic effect of venom of black widow spider, intentional self-harm
    T63313A Toxic effect of venom of black widow spider, assault,
    Y9226 Movie house or cinema as the place of occurrence of the external cause
    W6159XA Other contact with goose
    W370XXA Explosion of bicycle tire, initial encounter