Wednesday, July 1, 2015

SeaWorld Tragedy Impacts US Medical Coding System

NOTE: Descriptive medical and forensic language is used in this article to describe the "struck by" hazard posed by captive killer whales on their human handlers 

According to Forbes Magazine the US National Healthcare Expenditure (or NHE) is approximately 3 trillion dollars annually. A portion of that expenditure goes to pay approximately 90,000 certified medical coders around the country. 

For those that work directly within the US medical healthcare system you know that the industry, including hospitals, administrators, doctors, nurses, & staff is carefully & nervously monitoring the transition from the current ICD-9 to the ICD-10 system. 

Medical coders are in short supply as the system becomes more complex & detailed 

ICD is an acronym for the "International Classification of Diseases." These diagnostic codes describe what condition you are getting billed for by your physician or hospital. For example, there is a code for low back pain, 724.2 and migraine headache, 346.9. The United States is currently on the ninth edition, and after several delays will be transitioning to the ICD-10 in October. 

The Connection to SeaWorld

As described in the movie Blackfish, killer whales do not harm humans in the wild. And no one in the ocean has suffered a killer whale "struck by" injury. But the same is not true of trainers interacting with SeaWorld killer whales both in the US and abroad. In fact, two trainers have been killed specifically by "struck by" injuries. Both fatalities were attributable to captive SeaWorld killer whales. 

Read about Keto's "struck by" attack at Loro Parque, here

As described HERE, the new ICD-10 codes are being implemented to provide more "detailed healthcare data and a greater flow of that data to improve medical communication, which could contribute to advanced... protocols and clinical pathways." 

Now, as a result of the two tragic deaths in Orlando & Loro Parque, the US medical coding system has adopted a specific diagnosis in its ICD-10 library to address future instances of captive killer whale aggression. And no, this is not a joke: 

Initial encounter

Specific code icon 2015 ICD-10-CM Diagnosis Code W56.22XA  

Struck by orca, initial encounter

    2015 Billable Code Not A Principal Dx
  • W56.22XA describes the circumstance causing an injury, not the nature of the injury, and therefore should not be used as a principal diagnosis.
  • W56.22XA is a billable ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, W56.22XA - and all other ICD-10-CM codes - should only be used for training or planning purposes until then.
  • This is the American ICD-10-CM version of W56.22XA. Other international ICD-10 versions may differ.

Excerpt From Court Records Related to the SeaWorld Tragedy: 

This tragic description is likely the genesis of the new ICD-10 code being implemented in October 2015

Lastly, in an effort to educate physicians, nurses and staff, at least one hospital in Washington state has hung the following poster in its hallways to raise awareness regarding ICD-10 changes. In all likelihood the artists and employees who crafted this piece are not aware of its relationship to actual events perpetrated by incarcerated orca against their human handlers.

This is just another sign that it's time to #EmptyTheTanks