Thursday, July 19, 2012

ICD-10 Code for the Day

I received an email from a former coworker today, who was looking everywhere she could think of to find a posting I made about a code for the day.  She was checking Linkedin.  What she found was a snarky comment I made on my personal Facebook page earlier this week.  Actually, I also made another posting last week with a code for the day. So no wonder she thought it was "out there," so to speak.  And since I've been feeling rather uninspired to blog lately, I decided to go public with the code for the day and post it here.

Before I get to the first official Coder Coach Code for the Day, let me tell you this: these codes will be ICD-10 codes because I've been living and breathing ICD-10 lately and it's given me the opportunity to find some very interesting codes.  It's also led me to some very inspiring philosophical questions - you know, something along the line of why do we have an ICD-9-CM code for vomiting alone (787.03) and not one for vomiting in a group?  Couldn't a code for vomiting in a group come in very handy for St. Patrick's Day, New Years Eve, and countless 21st birthday parties?!  I know, I know, the code is really differentiating between vomiting with and without nausea.  But this gives you an idea of what goes through my mind as I read some code descriptions.  Besides, coding can be so boring, so why not make it fun and amusing?

So now that we've established my unique brand of coder humor, you need to know that there is no method to my madness regarding the selection of the code for the day.  I am not going to start at the beginning of ICD-10.  I am not going to randomly open an ICD-10-CM or ICD-10-PCS code book and pick a code.  The code (or codes) I choose will most likely be something inspired by a daily event or something I come across in my work and find incredibly interesting.  For example, last Tuesday, I worked a 16 hour day.  I started to come up with one code on the following day, but upon further reflection, I decided two would more accurately and completely report my condition (and we coders are about accuracy and completeness!):
  • Z72.820, Sleep deprivation 
  • F15.20, Other stimulant dependence [caffeine)] uncomplicated
I suppose coders who know ICD-10 will tell me I sequenced it wrong since the substance abuse code should go first followed by the Z code (which is ICD-10's equivalent of an ICD-9 V code), but I decided since one led to the other - that is, the sleep deprivation led to an excessive need for coffee on Wednesday, the sequencing was appropriate in my case.  And these codes will not be reported on a claim to CMS on behalf because 1) I didn't see a health care professional and 2) I don't have Medicare (how old do you think I am anyway?!). 

What I find interesting here is the new subcategory of Z codes for sleep problems - the one that jumped out at me was poor sleep hygiene.  I first found the set of codes while doing a documentation review for a sleep lab clinic in preparation for ICD-10.  I admit.  I had to google it.  What is sleep hygiene?  If I drool in my sleep, does that mean I have poor sleep hygiene?  Turns out it means a host of other things like irregular sleeping habits or leaving the lights on when you're trying to sleep.  Come to think of it, I think my head hit the pillow around 3am Wednesday morning and I was up again around 7am, so perhaps I should have added Z72.821, Inadequate sleep hygiene to the list above as well.

And really, I am not addicted to caffeine.  Anymore.  But I sure felt like I needed it on Wednesday.  The uncomplicated part could probably be argued by my boyfriend since I was pretty much exhausted for the rest of the week.  But really, the ICD-10 code is more referring to medical complications of drug dependence.  Think I'm kidding about the classification of caffeine as a drug you can be addicted to?  That part is no joke.  When you look up addiction, it takes you to dependence and caffeine is listed right there in the index!

This the kind of thing you'll have to look forward to in my Code for the Day posts.  Consider it my way of shaking my pom pons and getting you excited about ICD-10 again - since we still don't have a final rule yet.  I'm still plowing ahead and getting ready and I think the least I can do is make a little fun for my readers.

If you found a code that tickles your funny bone, send it to me at!