The ICD-10 Travesty


Right now the AAFP and the AMA are fighting with the government to delay the ICD-10 introduction.  You can see that here and here.  The reasons are obvious and are listed in both articles.  This next mandate is just a statistical nightmare whose use is so that others may play with the medical data even more (and make money off us).    Oh, and so insurance companies can find ways to NOT pay us.  Like all the other crap I spout on about in this website, there is no evidence that it helps patient care.   Isn’t that what healthcare should be about?  So why does the idiots at the AAFP and AMA wait until now to complain?  I have been talking about this for years!  This link even shows that the AMA adopted a resolution in 2011.  So what happened?  Wait a minute, doesn’t the AMA make money off the ICD somehow?  Or maybe it is just about putting on a show for them.  They can say they complained but, alas, the government didn’t listen.  Now pay your dues because they do so much for us.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  8 comments for “The ICD-10 Travesty

  1. Madelyn Sieraski
    March 7, 2014 at 12:11 pm

    I thought the increases in specificity of diabetes and CHF diagnosis were a pain. I had a few different cheat sheets for those. Now what. Keep the book with me. Sorry the EMR does not help with this – we still have to take time to find the diagnosis.

  2. tom walsh
    March 5, 2014 at 11:18 am

    You “forgot” to mention the addition of a few more codes to the ICD list. The present number is 17,000 and the new list adds “a few” so the new total is 155,000 (not a misprint or typo — One Hundred Fifty Five Thousand codes. YIPES !!!
    Here is the article spelling it out —

    Code Chaos
    Another nightmare for doctors, courtesy of the federal government
    Mar 10, 2014, Vol. 19, No. 25 • By STEPHEN F. HAYES
    Share on email

    Ever considered suicide by jellyfish? Have you ended up in the hospital after being injured during the forced landing of your spacecraft? Or been hurt when you were sucked into the engine of an airplane or when your horse-drawn carriage collided with a trolley?
    Dave Malan

    Chances are slim.

    But should any of these unfortunate injuries befall you after October 1, 2014, your doctor, courtesy of the federal government, will have a code to record it. On that date, the United States is scheduled to implement a new system for recording injuries, medical diagnoses, and inpatient procedures called ICD-10​—​the 10th version of the International Classification of Diseases propagated by the World Health Organization in Geneva, Switzerland. So these exotic injuries, codeless for so many years, will henceforth be known, respectively, as T63622A (Toxic effect of contact with other jellyfish, intentional self-harm, initial encounter), V9542XA (Forced landing of spacecraft injuring occupant, initial encounter), V9733XA (Sucked into jet engine, initial encounter), and V80731A (Occupant of animal-drawn vehicle injured in collision with streetcar, initial encounter).

    The coming changes are vast. The number of codes will explode​—​from 17,000 under the current system to 155,000 under the new one, according to the Centers for Medicare and Medicaid Services (CMS).

    The transition to ICD-10 was planned long before Congress passed the Affordable Care Act in 2010. But Obama administration officials say it is a critical part of the coming reforms. “ICD-10 is the foundation for health care reform,” said Jeff Hinson, a CMS regional administrator, in a conference call about ICD-10 for providers in Colorado.

    • tom walsh
      March 5, 2014 at 11:20 am

      Sorry, the complete article is here —

      Have a great month reading and memorizing all the new codes.

    • R Watkins
      March 5, 2014 at 12:54 pm

      Don’t blame the WHO for this mess.

      Each country designs its own version of ICD-10. Most countries now using it have about 15-20K codes, close to what we have currently.

      This Rosemary’s baby is entirely the product of CMS and HHS, under both Democratic and Republican administrations.

      • Pat
        March 5, 2014 at 5:47 pm

        Then “W.H.O.” Forced “U.S.” To have an ICD-10 at all?

        Yes, it is a bi-partisan abuse of power, which is hardly a defense.

  3. DrHockey
    March 5, 2014 at 11:09 am

    From, author Dr. David Pittman:

    W30.3XXA: Contact with grain storage elevator, initial encounter (In fact, there is a whole section of ICD-10 dealing with contacts with farm equipment including hay derricks and combine harvesters.)

    W21.04: Struck by golf ball (Think “Caddyshack,” in memoriam Harold Ramis. There are separate codes for being hit by a football, soccer ball, baseball, basketball, volleyball, and softball.)

    W56.21xD: Bitten by orca, subsequent encounter

    Z62.891: Sibling rivalry

    V97.33XD: Sucked into jet engine, subsequent encounter

    W61.92: Struck by other birds (There are also separate billing codes for being struck by parrots, macaws, psittacines, chickens, geese, and ducks. W61.92 is for all other types of birds.)

    Z63.1: Problems in relationship with in-laws

    W45.8XXA: Other foreign body or object entering through skin, initial encounter

    V52.2XXA: Person on outside of pick-up truck or van injured in collision with two- or three-wheeled motor vehicle in nontraffic accident, initial encounter

    V00.32: Snow-ski accident

    X92.0: Assault by drowning and submersion while in bathtub

    W00.1: Fall from stairs and steps due to ice and snow

    To suggest a code for this list, email [email protected].

  4. Randy
    March 3, 2014 at 1:32 pm

    Really it raises two topics. The first is ICD-10, which will raise costs and the hassle factor for all of us while providing nothing in the way of improving care. I can see some of the ICD-9 codes are overly broad and antiquated. but it seems like some minor tweaks would have been all it needed. I don’t see any utility to specifying something like a phalangeal fracture down to L vs R, which finger, proximal, medial or distal, routine vs delayed healing, non-union or malunion, and initial vs follow-up visit. Heck half the time they come in a month after the injury and I don’t even do anything for it except tell them it’ll hurt for a while.

    The other issue is the lack of effectiveness from the AAFP and AMA, who seem to have lost touch with many practicing physicians. As far as I can tell their policy is “we must do what the government wants so we can keep our seat at the table”. Who knows what they are doing at the table, possibly they are underneath it, or maybe they are at the “kiddie table” like when you had Thanksgiving without enough seats to go around and the kids had to sit at the Fisher-Price picnic table.

  5. Pat
    March 3, 2014 at 9:10 am

    How very gracious of AMA prez Hoven to speak out against ICD-10 after the fix is in. Has she ever spoken against the large-scale government provision of health care? Fellow readers might find my take a bit tendentious – okay, maybe a lot – but this is only the latest, direct result in government involvement in health care. Why should any of us give a damn what the W.H.O. wants for data collection? Because the U.S. bureaucrats who write much of our paychecks and practically all of our rules say so.

    If there were ever any use whatsoever to the AMA or AAFP, this abusive, pointless horseshit would have been stopped long ago. Instead, these Vichy organizations continue to take Uncle Sam’s table scraps and goodwill promises, while rear-ending their shrinking memberships.

    Note to would-be med students: if you’re the sort who reads this story and wants nothing to do with 21’st century health care, then Bravo!, you are one of the smart ones; if you’re the sort who thinks it’s no big deal, and that being ordered about is a noble privilege, then you’re not the sort I would want (but will get stuck with) for my doctor.

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