Lawmaker rejects medical code mandate, mocks nine codes for being ‘assaulted by a turkey’

Poe was talking about the mandate from the Department of Health and Human Services that health providers must start using ICD-10 starting in October 2014. The coding system is the latest iteration of the International Classification of Diseases (ICD).

The U.S. currently uses the ICD-9 system, which has about 18,000 codes for various injuries and diseases. The latest version sets up more than 140,000 codes, and is already being used by dozens of developed countries around the world.

{mosads}But this change means health care providers and insurers will need to use the codes to ensure reimbursement for services, which will slow their work down and cost tens of thousands of dollars to implement.

Poe said much of the problem relates to the level of detail in the new coding system. He cited the various ways the code envisions being injured by a turkey as a prime example of how the new system is excessive.

“There is a code for being assaulted by a turkey for the first time, there is a code for being assaulted by the turkey a second time,” Poe said. “There are nine codes. The doctor must get the right code or he’s in violation of the law.

“Seems nine codes for a turkey assault is a bit silly,” he added.

He said the ICD-10 system has five different codes for being hit in the face by a basketball, including one indicating that these injuries are “habitual.”

“There are even three new codes for being injured when you walk into a lamppost,” he said. “You walk into a lamppost for the first time, that’s one code. You walk into a lamppost for the second time, oh, that’s a different code.

“You walk into a lamppost habitually, yet that is even a different code, and the doctor must get it right because he’s in violation of federal regulators if he doesn’t get it right.”

Poe also noted that if a patient was injured in a chicken coop, the doctor will have to use the right code for that, Y972. For a patient hurt in an art gallery, the code is Y92250, Poe said.

He said the cost of compliance with ICD-10 will be about $80,000 per individual doctor, and for practices with five to ten doctors, about $250,000,

The Centers for Medicare and Medicaid Services (CMS) has said on its website that the reason the U.S. is moving to ICD-10 is precisely because ICD-9 is not descriptive enough about injuries and illnesses.

“The transition is occurring because ICD-9 codes have limited data about patients’ medical conditions and hospital inpatient procedures,” CMS says. “ICD-9 is 30 years old, it has outdated and obsolete terms, and is inconsistent with current medical practices.”

“Also, the structure of ICD-9 limits the number of new codes that can be created, and many ICD-9 categories are full,” CMS adds. “A successful transition to ICD-10 is vital to transforming our nation’s health care system.”


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