Tuesday, August 28, 2012

Code for the Day: Will Insurance Cover T75.01xxA while Y93.11?

It hardly seems possible, but Labor Day weekend is upon us and September is only a few days away.  As the unofficial end of summer, that means one thing in Colorado - all of the pools will be closing this weekend.  It's my last chance to get to the pool before they abruptly drain it and cover it over.  The only time it will be appealing until next Memorial Day weekend is when it snows enough to partially coat the pool cover and make it look like a picturesque iced-over pond. 

So this weekend I'm hoping the super hot weather we're having this week carries over through Monday without any thunder storms. You see, I'm old school when it comes to swimming. 

All those rules that seemed so ludicrous when I was a kid now make perfect sense.  Don't run around the pool because it's slick and having suffered my share of skinned knees from falling pool side, I get it.  Don't eat right before you swim because you might get a cramp and drown.  And finally, the second you hear thunder, get out of the pool.

Apparently these rules no longer apply, though.  There is a swimming pool within clear view of my office window and one of my favorite summer pastimes is watching people hang out in the pool during  thunderstorms.  Actually, most of the time, they move to the hot tub instead.  Maybe hot water is safer than cold in an electrical storm.  One day I watched as it poured rain with crazy thunder and lightning and there were 3 or 4 people in the hot tub.  With umbrellas.  I suppose they didn't want to get their hair wet as they sat in a tub of water.  I wondered, though, if they had given any consideration to the lightning rods in their hands.

So it got me pondering.  With these new ICD-10-CM codes, the insurance company will be able to tell just exactly what you were doing when you were struck by lightning.  Since it's a well-known fact that water is an excellent conductor of electricity, will insurance companies punish their customers by refusing to pay for accidents incurred while they were doing something that was, shall we say, not the smartest thing in the world?  More specifically, will insurance cover T75.01xxA (Shock due to being struck by lightning, initial encounter) while Y93.11 (Activity, swimming)?  

I'm not the first to wonder.  About a year ago, the Wall Street Journal published an article questioning the need for thousands of new codes in ICD-10-CM.  And while it may seem ridiculous to have some of the codes, I've seen more than one code that made me exclaim, "Finally!" - because it is something I've seen documented before.  The people at the Wall Street Journal may not understand, but the codes are used for more than payment - a lot of statistics you hear reported on the evening news ("x number of people died in car accidents last year") comes from coded data.

It will be interesting to see, though, what insurance companies do with this information.  It actually gives me another idea - I've never been able to watch Jackass the Movie all the way through.  But it might be fun to code in ICD-10-CM!