Dear Patients:

Here is what you are missing.  ICD-10 is a brilliant new system that allows doctors, hospitals, insurance companies, and government agencies improve the quality of care by categorizing problems patients have and reasons they visit the doctor\’s office.  It improves upon the previous system (cleverly named ICD-9) by expanding the number of codes by 500%.  This will significantly raise the morale of medical providers everywhere and will dramatically reduce the cost of care.

Just a glimpse into the ICD-10 shows how to code the all-too-common problem of when people are injured on railway vehicles (which are not streetcars, mind you).  I think it is fitting, when discussing the subject of ICD codes, to start with the area of train-wrecks…

Occupant of railway train or railway vehicle injured in transport accident V81- >

Type 1 Excludes 

• streetcar (V82.-)

Includes 

• derailment of railway train or railway vehicle
• person on outside of train

 V81 Occupant of railway train or railway vehicle injured in transport accident

 V81.0 Occupant of railway train or railway vehicle injured in collision with motor vehicle in nontraffic accident

•  V81.0XXA …… initial encounter
•  V81.0XXD …… subsequent encounter
•  V81.0XXS …… sequela

 V81.1 Occupant of railway train or railway vehicle injured in collision with motor vehicle in traffic accident

•  V81.1XXA …… initial encounter
•  V81.1XXD …… subsequent encounter
•  V81.1XXS …… sequela

V81.2 Occupant of railway train or railway vehicle injured in collision with or hit by rolling stock

•  V81.2XXA …… initial encounter
•  V81.2XXD …… subsequent encounter
•  V81.2XXS …… sequela

 V81.3 Occupant of railway train or railway vehicle injured in collision with other object

•  V81.3XXA …… initial encounter
•  V81.3XXD …… subsequent encounter
•  V81.3XXS …… sequela

 V81.4 Person injured while boarding or alighting from railway train or railway vehicle

•  V81.4XXA …… initial encounter
•  V81.4XXD …… subsequent encounter
•  V81.4XXS …… sequela

 V81.5 Occupant of railway train or railway vehicle injured by fall in railway train or railway vehicle

•  V81.5XXA …… initial encounter
•  V81.5XXD …… subsequent encounter
•  V81.5XXS …… sequela

 V81.6 Occupant of railway train or railway vehicle injured by fall from railway train or railway vehicle

•  V81.6XXA …… initial encounter
•  V81.6XXD …… subsequent encounter
•  V81.6XXS …… sequela

 V81.7 Occupant of railway train or railway vehicle injured in derailment without antecedent collision

•  V81.7XXA …… initial encounter
•  V81.7XXD …… subsequent encounter
•  V81.7XXS …… sequela

 V81.8 Occupant of railway train or railway vehicle injured in other specified railway accidents

 V81.81 Occupant of railway train or railway vehicle injured due to explosion or fire on train

•  V81.81XA …… initial encounter
•  V81.81XD …… subsequent encounter
•  V81.81XS …… sequela

 V81.82 Occupant of railway train or railway vehicle injured due to object falling onto train

•  V81.82XA …… initial encounter
•  V81.82XD …… subsequent encounter
•  V81.82XS …… sequela

 V81.83 Occupant of railway train or railway vehicle injured due to collision with military vehicle

•  V81.83XA …… initial encounter
•  V81.83XD …… subsequent encounter
•  V81.83XS …… sequela

 V81.89 Occupant of railway train or railway vehicle injured due to other specified railway accident

•  V81.89XA …… initial encounter
•  V81.89XD …… subsequent encounter
•  V81.89XS …… sequela

 V81.9 Occupant of railway train or railway vehicle injured in unspecified railway accident

•  V81.9XXA …… initial encounter
•  V81.9XXD …… subsequent encounter
•  V81.9XXS …… sequela

It should be obvious, that to lump streetcar-related injuries would do a great injustice to those millions injured in that setting.  Fear not!  Streetcar advocates get their they desire (but not ones that are drawn by animals)…

Occupant of powered streetcar injured in transport accident V82- >

Type 1 Excludes 

• bus (V70-V79)
• motorcoach (V70-V79)
• nonpowered streetcar (V76.-)
• train (V81.-)

Includes 

• interurban electric car
• person on outside of streetcar
• tram (car)
• trolley (car)

 V82 Occupant of powered streetcar injured in transport accident

 V82.0 Occupant of streetcar injured in collision with motor vehicle in nontraffic accident

•  V82.0XXA …… initial encounter
•  V82.0XXD …… subsequent encounter
•  V82.0XXS …… sequela

 V82.1 Occupant of streetcar injured in collision with motor vehicle in traffic accident

•  V82.1XXA …… initial encounter
•  V82.1XXD …… subsequent encounter
•  V82.1XXS …… sequela

 V82.2 Occupant of streetcar injured in collision with or hit by rolling stock (is that soup brought to a boil?)

•  V82.2XXA …… initial encounter
•  V82.2XXD …… subsequent encounter
•  V82.2XXS …… sequela

 V82.3 Occupant of streetcar injured in collision with other object

•  V82.3XXA …… initial encounter
•  V82.3XXD …… subsequent encounter
•  V82.3XXS …… sequela

 V82.4 Person injured while boarding or alighting from streetcar

•  V82.4XXA …… initial encounter
•  V82.4XXD …… subsequent encounter
•  V82.4XXS …… sequela

 V82.5 Occupant of streetcar injured by fall in streetcar

•  V82.5XXA …… initial encounter
•  V82.5XXD …… subsequent encounter
•  V82.5XXS …… sequela

 V82.6 Occupant of streetcar injured by fall from streetcar

•  V82.6XXA …… initial encounter
•  V82.6XXD …… subsequent encounter
•  V82.6XXS …… sequela

 V82.7 Occupant of streetcar injured in derailment without antecedent collision

•  V82.7XXA …… initial encounter
•  V82.7XXD …… subsequent encounter
•  V82.7XXS …… sequela

 V82.8 Occupant of streetcar injured in other specified transport accidents

•  V82.8XXA …… initial encounter
•  V82.8XXD …… subsequent encounter
•  V82.8XXS …… sequela

 V82.9 Occupant of streetcar injured in unspecified traffic accident

•  V82.9XXA …… initial encounter
•  V82.9XXD …… subsequent encounter
•  V82.9XXS …… sequela

So what if you are injured while riding a horse?  Or riding a llama-drawn cart that is hit by a Humvee?  Don\’t worry.  ICD-10 has got you covered too!

Animal-rider or occupant of animal-drawn vehicle injured in transport accident V80- >

 V80 Animal-rider or occupant of animal-drawn vehicle injured in transport accident

 V80.0 Animal-rider or occupant of animal drawn vehicle injured by fall from or being thrown from animal or animal-drawn vehicle in noncollision accident

 V80.01 Animal-rider injured by fall from or being thrown from animal in noncollision accident

 V80.010 Animal-rider injured by fall from or being thrown from horse in noncollision accident

•  V80.010A …… initial encounter
•  V80.010D …… subsequent encounter
•  V80.010S …… sequela

 V80.018 Animal-rider injured by fall from or being thrown from other animal in noncollision accident

•  V80.018A …… initial encounter
•  V80.018D …… subsequent encounter
•  V80.018S …… sequela

 V80.02 Occupant of animal-drawn vehicle injured by fall from or being thrown from animal-drawn vehicle in noncollision accident

•  V80.02XA …… initial encounter
•  V80.02XD …… subsequent encounter
•  V80.02XS …… sequela

 V80.1 Animal-rider or occupant of animal-drawn vehicle injured in collision with pedestrian or animal

 V80.11 Animal-rider injured in collision with pedestrian or animal

•  V80.11XA …… initial encounter
•  V80.11XD …… subsequent encounter
•  V80.11XS …… sequela

 V80.12 Occupant of animal-drawn vehicle injured in collision with pedestrian or animal

•  V80.12XA …… initial encounter
•  V80.12XD …… subsequent encounter
•  V80.12XS …… sequela

 V80.2 Animal-rider or occupant of animal-drawn vehicle injured in collision with pedal cycle

 V80.21 Animal-rider injured in collision with pedal cycle

•  V80.21XA …… initial encounter
•  V80.21XD …… subsequent encounter
•  V80.21XS …… sequela

 V80.22 Occupant of animal-drawn vehicle injured in collision with pedal cycle

•  V80.22XA …… initial encounter
•  V80.22XD …… subsequent encounter
•  V80.22XS …… sequela

 V80.3 Animal-rider or occupant of animal-drawn vehicle injured in collision with two- or three-wheeled motor vehicle

 V80.31 Animal-rider injured in collision with two- or three-wheeled motor vehicle

•  V80.31XA …… initial encounter
•  V80.31XD …… subsequent encounter
•  V80.31XS …… sequela

 V80.32 Occupant of animal-drawn vehicle injured in collision with two- or three-wheeled motor vehicle

•  V80.32XA …… initial encounter
•  V80.32XD …… subsequent encounter
•  V80.32XS …… sequela

 V80.4 Animal-rider or occupant of animal-drawn vehicle injured in collision with car, pick-up truck, van, heavy transport vehicle or bus

 V80.41 Animal-rider injured in collision with car, pick-up truck, van, heavy transport vehicle or bus

•  V80.41XA …… initial encounter
•  V80.41XD …… subsequent encounter
•  V80.41XS …… sequela

 V80.42 Occupant of animal-drawn vehicle injured in collision with car, pick-up truck, van, heavy transport vehicle or bus

•  V80.42XA …… initial encounter
•  V80.42XD …… subsequent encounter
•  V80.42XS …… sequela

 V80.5 Animal-rider or occupant of animal-drawn vehicle injured in collision with other specified motor vehicle

 V80.51 Animal-rider injured in collision with other specified motor vehicle

•  V80.51XA …… initial encounter
•  V80.51XD …… subsequent encounter
•  V80.51XS …… sequela

 V80.52 Occupant of animal-drawn vehicle injured in collision with other specified motor vehicle

•  V80.52XA …… initial encounter
•  V80.52XD …… subsequent encounter
•  V80.52XS …… sequela

 V80.6 Animal-rider or occupant of animal-drawn vehicle injured in collision with railway train or railway vehicle

 V80.61 Animal-rider injured in collision with railway train or railway vehicle

•  V80.61XA …… initial encounter
•  V80.61XD …… subsequent encounter
•  V80.61XS …… sequela

 V80.62 Occupant of animal-drawn vehicle injured in collision with railway train or railway vehicle

•  V80.62XA …… initial encounter
•  V80.62XD …… subsequent encounter
•  V80.62XS …… sequela

 V80.7 Animal-rider or occupant of animal-drawn vehicle injured in collision with other nonmotor vehicles

 V80.71 Animal-rider or occupant of animal-drawn vehicle injured in collision with animal being ridden

 V80.710 Animal-rider injured in collision with other animal being ridden

•  V80.710A …… initial encounter
•  V80.710D …… subsequent encounter
•  V80.710S …… sequela

 V80.711 Occupant of animal-drawn vehicle injured in collision with animal being ridden

•  V80.711A …… initial encounter
•  V80.711D …… subsequent encounter
•  V80.711S …… sequela

 V80.72 Animal-rider or occupant of animal-drawn vehicle injured in collision with other animal-drawn vehicle

 V80.720 Animal-rider injured in collision with animal-drawn vehicle

•  V80.720A …… initial encounter
•  V80.720D …… subsequent encounter
•  V80.720S …… sequela

 V80.721 Occupant of animal-drawn vehicle injured in collision with other animal-drawn vehicle

•  V80.721A …… initial encounter
•  V80.721D …… subsequent encounter
•  V80.721S …… sequela

 V80.73 Animal-rider or occupant of animal-drawn vehicle injured in collision with streetcar

 V80.730 Animal-rider injured in collision with streetcar

•  V80.730A …… initial encounter
•  V80.730D …… subsequent encounter
•  V80.730S …… sequela

 V80.731 Occupant of animal-drawn vehicle injured in collision with streetcar

•  V80.731A …… initial encounter
•  V80.731D …… subsequent encounter
•  V80.731S …… sequela

 V80.79 Animal-rider or occupant of animal-drawn vehicle injured in collision with other nonmotor vehicles

 V80.790 Animal-rider injured in collision with other nonmotor vehicles

•  V80.790A …… initial encounter
•  V80.790D …… subsequent encounter
•  V80.790S …… sequela

 V80.791 Occupant of animal-drawn vehicle injured in collision with other nonmotor vehicles

•  V80.791A …… initial encounter
•  V80.791D …… subsequent encounter
•  V80.791S …… sequela

 V80.8 Animal-rider or occupant of animal-drawn vehicle injured in collision with fixed or stationary object

 V80.81 Animal-rider injured in collision with fixed or stationary object

•  V80.81XA …… initial encounter
•  V80.81XD …… subsequent encounter
•  V80.81XS …… sequela

 V80.82 Occupant of animal-drawn vehicle injured in collision with fixed or stationary object

•  V80.82XA …… initial encounter
•  V80.82XD …… subsequent encounter
•  V80.82XS …… sequela

 V80.9 Animal-rider or occupant of animal-drawn vehicle injured in other and unspecified transport accidents

 V80.91 Animal-rider injured in other and unspecified transport accidents

 V80.910 Animal-rider injured in transport accident with military vehicle

•  V80.910A …… initial encounter
•  V80.910D …… subsequent encounter
•  V80.910S …… sequela

 V80.918 Animal-rider injured in other transport accident

•  V80.918A …… initial encounter
•  V80.918D …… subsequent encounter
•  V80.918S …… sequela

 V80.919 Animal-rider injured in unspecified transport accident

•  V80.919A …… initial encounter
•  V80.919D …… subsequent encounter
•  V80.919S …… sequela

 V80.92 Occupant of animal-drawn vehicle injured in other and unspecified transport accidents

 V80.920 Occupant of animal-drawn vehicle injured in transport accident with military vehicle

•  V80.920A …… initial encounter
•  V80.920D …… subsequent encounter
•  V80.920S …… sequela

 V80.928 Occupant of animal-drawn vehicle injured in other transport accident

•  V80.928A …… initial encounter
•  V80.928D …… subsequent encounter
•  V80.928S …… sequela

 V80.929 Occupant of animal-drawn vehicle injured in unspecified transport accident

•  V80.929A …… initial encounter
•  V80.929D …… subsequent encounter
•  V80.929S …… sequela

Now, if you are not on land, but in the water and happen to encounter a non-venemous animal (who doesn\’t experience this daily?), then there are plenty of codes for you!

Contact with nonvenomous marine animal W56- >

Type 1 Excludes 

• contact with venomous marine animal (T63.-)

 W56 Contact with nonvenomous marine animal

 W56.0 Contact with dolphin

•  W56.01 Bitten by dolphin
  •  W56.01XA …… initial encounter
  •  W56.01XD …… subsequent encounter
  •  W56.01XS …… sequela
•  W56.02 Struck by dolphin
  •  W56.02XA …… initial encounter
  •  W56.02XD …… subsequent encounter
  •  W56.02XS …… sequela
•  W56.09 Other contact with dolphin
  •  W56.09XA …… initial encounter
  •  W56.09XD …… subsequent encounter
  •  W56.09XS …… sequela

 W56.1 Contact with sea lion

•  W56.11 Bitten by sea lion
  •  W56.11XA …… initial encounter
  •  W56.11XD …… subsequent encounter
  •  W56.11XS …… sequela
•  W56.12 Struck by sea lion
  •  W56.12XA …… initial encounter
  •  W56.12XD …… subsequent encounter
  •  W56.12XS …… sequela
•  W56.19 Other contact with sea lion
  •  W56.19XA …… initial encounter
  •  W56.19XD …… subsequent encounter
  •  W56.19XS …… sequela

 W56.2 Contact with orca (not to be confused with Okra, although there is some need for that code.)

•  W56.21 Bitten by orca
  •  W56.21XA …… initial encounter
  •  W56.21XD …… subsequent encounter
  •  W56.21XS …… sequela
•  W56.22 Struck by orca
  •  W56.22XA …… initial encounter
  •  W56.22XD …… subsequent encounter
  •  W56.22XS …… sequela
•  W56.29 Other contact with orca
  •  W56.29XA …… initial encounter
  •  W56.29XD …… subsequent encounter
  •  W56.29XS …… sequela

 W56.3 Contact with other marine mammals

•  W56.31 Bitten by other marine mammals
  •  W56.31XA …… initial encounter
  •  W56.31XD …… subsequent encounter
  •  W56.31XS …… sequela
•  W56.32 Struck by other marine mammals
  •  W56.32XA …… initial encounter
  •  W56.32XD …… subsequent encounter
  •  W56.32XS …… sequela
•  W56.39 Other contact with other marine mammals
  •  W56.39XA …… initial encounter
  •  W56.39XD …… subsequent encounter
  •  W56.39XS …… sequela

 W56.4 Contact with shark

•  W56.41 Bitten by shark
  •  W56.41XA …… initial encounter
  •  W56.41XD …… subsequent encounter
  •  W56.41XS …… sequela
•  W56.42 Struck by shark
  •  W56.42XA …… initial encounter
  •  W56.42XD …… subsequent encounter
  •  W56.42XS …… sequela
•  W56.49 Other contact with shark
  •  W56.49XA …… initial encounter
  •  W56.49XD …… subsequent encounter
  •  W56.49XS …… sequela

 W56.5 Contact with other fish

•  W56.51 Bitten by other fish
  •  W56.51XA …… initial encounter
  •  W56.51XD …… subsequent encounter
  •  W56.51XS …… sequela
•  W56.52 Struck by other fish
  •  W56.52XA …… initial encounter
  •  W56.52XD …… subsequent encounter
  •  W56.52XS …… sequela
•  W56.59 Other contact with other fish
  •  W56.59XA …… initial encounter
  •  W56.59XD …… subsequent encounter
  •  W56.59XS …… sequela

 W56.8 Contact with other nonvenomous marine animals

•  W56.81 Bitten by other nonvenomous marine animals
  •  W56.81XA …… initial encounter
  •  W56.81XD …… subsequent encounter
  •  W56.81XS …… sequela
•  W56.82 Struck by other nonvenomous marine animals
  •  W56.82XA …… initial encounter
  •  W56.82XD …… subsequent encounter
  •  W56.82XS …… sequela
•  W56.89 Other contact with other nonvenomous marine animals
  •  W56.89XA …… initial encounter
  •  W56.89XD …… subsequent encounter
  •  W56.89XS …… sequela

And, in case your doctor is having too much fun with ICD-10 and messes your care up, there is the beloved \”Medical Misadventure\” category (which is soon to become a sit-com on the Disney Channel).

Misadventures to patients during surgical and medical care Y62-Y69 >

Type 2 Excludes 

• breakdown or malfunctioning of medical device (during procedure) (after implantation) (ongoing use) (Y70-Y82)
• 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)

• Y62  Failure of sterile precautions during surgical and medical care
• Y63  Failure in dosage during surgical and medical care
• Y64  Contaminated medical or biological substances
• Y65  Other misadventures during surgical and medical care
• Y66  Nonadministration of surgical and medical care
• Y69  Unspecified misadventure during surgical and medical care

You can see how this will be useful and enjoyable for medical professionals everywhere, and how it will greatly improve the quality of care.  Yes, this is all real.  Be afraid, America.  Be Afraid.