Wednesday, August 1, 2012

Code for the Day: Crystal Gayle Syndrome (Don't it Make my Brown Eyes Blue) W36.1xxA

Like so many people right now, I am glued to my TV each night watching Team USA go for the gold.  My favorite is women's gymnastics and there really isn't much that can tear me away from watching it.  Especially now that I have DVR.  First disclosure: I record the games every night and am usually a couple of hours behind real time, so I still haven't seen all of last night's events yet, even though I've heard the spoilers (note to self, do not go on Facebook if you are recording the Olympics).  And this morning, when I woke up, I had this weird thought in my head.  Don't it make my brown eyes blue.  As in the Crystal Gayle song from the 70s (okay young'ens - google it!).  And it's link to the 1984 Olympics.

Disclosure number two: my brother tells me I remember the weirdest stuff.

As I was watching women's gymnastics one afternoon during the 1984 Olympics, my brother had an accident with a pair of needle nose pliers and a spray paint can.  The result was a literal explosion of blue spray paint in his face.  Thanks to a quick thinking neighbor who happened to be a painter, my brother didn't lose his eyesight.  Potential sight-saving tip here: petroleum jelly on wet paint keeps it from drying and preventing paint from gluing your eyes shut.  After an agonizing evening in the emergency room - because the only thing they had on the Olympics in the ER waiting room was... ick... wrestling - and a bazillion cc's of saline washed through his nose and eyes, my brother's face, nostrils, and eyes were no longer blue.  And not a drop of blue paint got on his white t-shirt.  Today, the family lovingly refers to this incident as the time my brother tried to turn his brown eyes blue (Crystal Gayle reference complete!).

When I first started coding, I shared a house with my brother.  And since I started out as an ER coder, I could often be heard saying, "There's an E code for that."  It didn't take him long to pick up on that and he'd start asking me, "Is there an E code for that?"  Well, Bro, I'm here to tell you that in ICD-10-CM there is not an E code for that because external cause codes now have different letters.  But there is, in fact an external cause code for that:
  • W36.1xxA, Explosion and rupture of aerosol can, initial encounter
I am happy to report that my brother learns from his mistakes and so this code was never needed:
  • W36.1xxD, Explosion and rupture of aerosol can, subsequent encounter

I was so excited to code this 28-year-old case today.  I couldn't wait to get to the activity because we have all these great new external cause codes for what the patient was doing at the time of the accident.  But alas, there is no code for the activity of painting.  It's good to know there is one for injury during rhythmic gymnastics, though.  I hope none of the Olympians have to use it.  Of note, there is a specific place of occurrence code:
  • Y92.015 Private garage of single-family (private) house as the place of occurrence of the external cause
That's pretty specific.  And although my brother is pretty smart today and very successful, I couldn't resist looking up "Moron" in ICD-10-CM and it gave me this code:
  • F70 Mild intellectual disabilities
I mean seriously, even I - the younger sibling - knew you never used a pair of needle nose pliers to puncture a paint can.