It turns out that the entire transition to the new ICD10 code set was just a joke perpetrated by a 13-year-old boy.
“I mean, who would take it seriously?” said RancheroBoy, using his screen name from MedicalCoders.com. He agreed to speak with us only on the condition that we not use his real name.
Hospitals and physicians’ offices nationwide were required to transition to the ICD10 code set for all diagnostic reporting as of October 1, 2015 — costing literally billions in health care dollars. Entire computer networks had to be redesigned, and the fantastically complicated software that supports the billing and information exchange between insurance companies, underwriters, and practice management services had to be rewritten from the ground up. It’s estimated that physicians each spent, on average, 20 hours in training, and the transition has cost an average medical office approximately $100,000 to prepare, purchase software, and train staff.
“Come on, I mean really, it was obviously just a set-up,” said RancheroBoy, laughing and wiping tears from his eyes. “Macaw attacks? Orcas? A visit for taking care of your fake vagina?”
“That last one was BiosphereNacho’s idea,” he added. “I thought it was so crazy; there was no way it would become official. I mean, come on!”
RancheroBoy was referring to code Z43.7, Encounter for attention to artificial vagina.
When asked about his other favorite codes, RancheroBoy listed V97.33XD, sucked into a jet engine, subsequent encounter (“Who could possibly survive that happening even once? And what kind of idiot would let it happen again?”), R46.1, Bizarre personal appearance (“That one was for this guy we know who totally looks like a pufferfish, I kid you not”), and V91.07XA, Burn due to water-skis on fire (“Ha! Come on, if anyone believed that was real, you must be a complete idiot!”)
We spoke with RancheroBoy’s mother, who confirmed that he had been, in her words, “Very naughty.”
“I mean, fun is fun,” she said, “but I hardly think crippling the entire health care system is what a 13-year-old boy should be doing. When I was his age we used to ride bikes and play with Jacks.”
RancheroBoy explained that the entire code set had been made up at the end of a friend’s birthday party, after they had tricked BaconHeadliner into taking his pants off. “That was, like, the ultimate prank. We told him he had like pudding or something on his pants, and the girls thought it was poo. He freaked, and then he was all like ‘that’s not funny’. BiosphereNacho was rolling on the floor.”
“Then, I don’t know why we started to think this, we wondered if, you know, we could bring the entire health care sector of the economy to its knees, you know, by insisting on this whole crazy new way of doing things. I guess we got carried away.”
Among RancheroBoy’s favorite invented codes are those dealing with animal attacks — including cows, macaws, sea cucumbers, and orcas. “Yeah, I mean, we need to know — did the macaw bite you, or did the orca slap you with his fin or whatever it’s called?”
“Of course, if the orca used a baseball bat, you’d need to code W56.22XS and W21.11XS — and of course add Y92.34 if it happened in a public swimming pool. You know, where you find orcas,” added RancheroBoy, “Though of course it depends if this was the first time it happened.”
At this point, RancheroBoy collapsed with laughter and was unable to answer further questions.
Roy Benaroch is a pediatrician who blogs at the Pediatric Insider. He is also the author of A Guide to Getting the Best Health Care for Your Child and the creator of The Great Courses’ Medical School for Everyone: Grand Rounds Cases.
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