Thursday, November 1, 2012

Code for the Day: Nuclear Radiation Exposure Leads to Cannibalism? (F50.8 and W88.1xxS)

I list a lot of movie references in my blogs.  There was a time when my movie collection rivaled the local video stores.  That was a long time and a lot of VHS tapes ago (and during the era of video stores!).  These days, my schedule prevents me from seeing the latest movie every couple of weeks and in fact, most of the time when I do take the time to unwind and watch a movie, I inevitably miss most of it when I fall asleep.  But I still love movies – usually funny movies, and of course, the quintessential chick flick.  But lately, at this time of year, I am in the mood for a scary movie or two.  And last weekend’s couch surfing adventure yielded two movies: Chernobyl Diaries and The Hills Have Eyes. Both of these movies bring to mind one word: “ew.”

Me, zombified.
I didn’t realize going into the double feature that the evening would have a distinct theme beyond the horror genre.  First we watched Chernobyl Diaries, where a group of young tourists take a forbidden tour into the town of Pripyat, near the Chernobyl Nuclear Power Plant.  Their van breaks down and one by one, they are attacked by an unseen force.  In the Hills Have Eyes, a nuclear bombing testing ground in New Mexico is home to miners who refused to leave during the testing.  After disabling a family’s truck and motor home, the deformed miners take revenge on the unsuspecting tourists.  After watching both movies, I came to a very troubling conclusion: exposure to excessive radiation turns people into cannibals.  So here are your somewhat belated codes for the day with a Halloween twist:

  • F50.8, Other eating disorders
  • W88.1xxS, Exposure to radioactive isotopes, sequela

I know what you’re thinking.  Cannibalism?  An eating disorder?  I usually come up with my codes for the day myself, but having done a little research and realizing that cannibalism is not classified by the Diagnostic Statistical Manual (DSM-IV) and therefore not by ICD-10-CM, I consulted a colleague.  We had a rather sordid discussion on how best to classify these radiation victims.  And this is what we came up with: Merriam-Webster defines pica as “an abnormal desire to eat substances (as chalk or ashes) not normally eaten.”  We found a reference that stated that a person who chews his own fingernails and then swallows them could be classified as having pica.  And this type of self-pica is considered a type of cannibalism. I know we’re taking liberties here, but I’m coding characters from a movie.  I really don’t know what I will do should I ever have to code a real case for a cannibal.  Let’s hope it never comes to that.  

The exposure code was the easy one.  Notice the 7th character extension of “S” for sequela.  The Chernobyl disaster occurred in 1986.  The nuclear testing in The Hills Have Eyes appears to have occurred in the 1950s, so these particular radiation-infused cannibals were all suffering long term effects, or sequelae, from their radiation injuries.

As for the horror movies, I’m ready to trade them in for the warm and fuzzy holiday movies!