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Here's the full list of codes for "Bitten by ____, _____ encounter" https://www.icd10data.com/ICD10CM/Codes/V00-Y99/W50-W64/W61- https://www.icd10data.com/ICD1
by bradgessler 3y ago
Here's the full list of codes for "Bitten by ____, _____ encounter"
https://www.icd10data.com/ICD10CM/Codes/V00-Y99/W50-W64/W61- https://www.icd10data.com/ICD10CM/Codes/V00-Y99/W50-W64/W61-
The hierarchy looks like this:
W61.6 Contact with duck
= W61.61 Bitten by duck
== W61.61XA …… initial encounter
== W61.61XD …… subsequent encounter
== W61.61XS …… sequela
= W61.62 Struck by duck
== W61.62XA …… initial encounter
== W61.62XD …… subsequent encounter
== W61.62XS …… sequela
= W61.69 Other contact with duck
== W61.69XA …… initial encounter
== W61.69XD …… subsequent encounter
== W61.69XS …… sequela
There's codings like this for parrots, macaws, chickens, turkey, etc.
Hell there's an entire section for alligators and crocodiles at https://www.icd10data.com/ICD10CM/Codes/V00-Y99/W50-W64/W58- https://www.icd10data.com/ICD10CM/Codes/V00-Y99/W50-W64/W58- that includes crushing, bites, etc.
- kderbyma 3y agoBeagle Boys health records probably have a lot of W61.6... on their files.
- guidoism 3y agoDucktales?
- coding123 3y agoI wonder if bitten by duck is more expensive that bitten by chicken.
- chimeracoder 3y ago> I wonder if bitten by duck is more expensive that bitten by chicken. They're diagnosis codes, so they're mostly irrelevant for determining cost. You don't get charged for "having the flu" - you get charged for the various services or treatments you received in the course of your illness. Diagnosis codes do factor into claims reimbursement indirectly. For example, some services can be done either as treatment or for preventive purposes, and insurance is legally required[0] to cover the latter at no cost to the patient, whereas insurers can require that the patient pay for the former. But that's pretty indirect - by and large, the payment agreements between insurers and in-network providers apply to services rendered, which doesn't really factor in diagnoses codes (assuming that the service was appropriate for the diagnosis in the first place). That's assuming fee-for-service: capitation is a whole other model, although in that case it's still typically determined independent of the diagnosis, because the whole point of capitation is to minimize care delivered. But getting bitten by a duck vs. a chicken is unlikely to cause any difference in the price you pay, unless: (a) the injuries from the duck bite were significantly different from the injuries from a chicken bite, or (b) one was considered an occupational exposure and the other wasn't (in which case worker's compensation would be billed for it). [0] well, until March of this year, when a judge in Texas overturned that clause of the ACA
- btown 3y agoNot even ironically, this all smells of insurers wanting sufficient data to raise rates on different types of farmers and breeders. It might be scandalous if they didn’t collect the data and then were biased against, say, chicken farmers. But if they do collect the data, they can say they analyzed it, whether or not they did, to support any kind of tactic they desired.
- lotsofpulp 3y agoYou are smelling something that is not there because, in the US, health insurers are only allowed a few factors to determine someone’s premium. https://www.healthcare.gov/how-plans-set-your-premiums https://www.healthcare.gov/how-plans-set-your-premiums > Five factors can affect a plan’s monthly premium: location, age, tobacco use, plan category, and whether the plan covers dependents.
- btown 3y agoTrue for marketplace insurance, but private plans (which companies would provide to employees at enticingly lower premiums than public options) vary considerably. See, for but one example, https://www.lgbtmap.org/img/maps/citations-nondisc-insurance.pdf https://www.lgbtmap.org/img/maps/citations-nondisc-insurance...
- chimeracoder 3y agoThose are ICD codes, which are not the same as billing codes. ICD represent diagnoses, not services rendered. ICD codes also are somewhat procedural in their generation - that is, there's a whole grammar to how they're formed. For example, you'll have something like "contact with", then a whole number of different animals, and then each of those will have three different varieties (initial encounter, subsequent encounter, sequela). So it does end up with very funny lists, like the one you posted, but: (a) most of those codes are never used, and (b) just because it's assigned just means that it's a "grammatically valid" combination, not that it has any particular clinical relevance. The goal is to assign granular and hierarchical codes at the outset, to allow for more robust analysis later, at least in theory. But again, all of that is irrelevant to billing, because while ICD codes are typically submitted along with the billing info (along with a whole other slew of data), ICD codes are not the actual code that's billed - there's a whole separate list of codes used for billing.
- marcus0x62 3y agoThat's really interesting, because I had a customer that did nothing but provide medical billing services, and about 15 years ago when the industry was moving from ICD-9 to ICD-10, that customer seemed really focused on their billing coders learning ICD-10.
- chimeracoder 3y ago> That's really interesting, because I had a customer that did nothing but provide medical billing services, and about 15 years ago when the industry was moving from ICD-9 to ICD-10, that customer seemed really focused on their billing coders learning ICD-10. I mean, sure? You can't bill for a service without a diagnosis code that justifies the service. Anyone who does medical billing is going to need to be able to format that data. But ICD codes are not the codes that insurers are billed for - billing codes are completely separate and not even determined by the same party.
- baishtar 3y agoThat's to ensure that the service provided (procedure code) matches the diagnosis. For example, the procedure (HCPCS) code "71045" corresponds with the procedure "RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW" for billing purposes. If you were to match that up with the diagnosis code (ICD10) S80.211 for "Abrasion, right knee" there would be a mismatch between the diagnosis and the procedure. This happens all the time due to human error and often results in insurance denials, which sadly take a long time to fix since now you have to get MORE HUMANS involved.
- maweaver 3y agoBut why? I could understand from a treatment perspective the type of animal mattering (but even then initial vs subsequent encounters?). From a billing perspective, wouldn't it make sense to have animal bite exam fee, with possible additional charges for bandaging, stitches, rabies shot, etc based on doctor's discretion?
- 88913527 3y agoWell, it employs a lot of people to have this complex billing. And whoever argued the need for it got to do some major empire building, maybe scored a promotion.
- brendanyounger 3y agoMedical billing is a dreary business. Check out https://www.reddit.com/r/CodingAndBilling/ https://www.reddit.com/r/CodingAndBilling/. It's not clear that anyone is _trying_ to build an empire out of this. More likely, they're trying to build a bigger trash heap to climb on top of.
- nradov 3y agoNo one got a promotion out of it. The USA adopted the WHO ICD code system for diagnoses on billing claims because it was good enough, and much easier than defining a whole new code system. Some of the codes are never used, but so what.
- Ylpertnodi 3y ago[flagged]
- mensetmanusman 3y agoBitten by a communist just yesterday. I wonder how it is coded.
- squeaky-clean 3y agoLooks like it's W50.3XXA if it was accidental. Or Y04.8XXA if it was intentional. If you were the communist and bit yourself on the upper right arm it would be S40.871A or S41.151A depending on how deep the bite went.
- deleted 3y ago[deleted]
- mensetmanusman 3y ago"I'd like to file a complaint. This is my fourth time being bitten by a duck not my second time. You have overcharged me!" This is possible in America today. Great job post ww2 employer coverage side effects!
- arcticfox 3y agoAs others have explained, the subsequent encounter is for a follow-up visit, not a repeated duck attack.
- galleywest200 3y agoThis is still silly.
- deleted 3y ago[deleted]
- Alupis 3y agoIt's not when you want statistics about all injury types, treatments, etc.
- deleted 3y ago[deleted]
- boredpeter 3y agoYou don’t need arbitrary codes to get statistics for something that can be typed in a description field.
- paulddraper 3y agoYou don't need to type arbitrary descriptions for something that can be a standardized code.
- vanattab 3y ago
- deleted 3y ago[deleted]
- tanseydavid 3y ago>> There's codings like this for parrots, macaws, chickens, turkey, etc. Yeah, but how much do they cost? </sarc>
- pixelatedindex 3y agoThankfully, W61 is a non-billable code family… hope it stays that way! I do wonder what all the billable code families are, maybe I should find out.
- apwheele 3y agoThe Z codes (ICD to be specific) are similar. Although those two are not exhaustive -- it can be conditional so can be confusing. You have different rules for chronic conditions, so for example something could be rolled up into a billable DRG one visit, but should not be included in a follow up visit. The DRG example on this website is interesting -- so I think these are valuable services, but I look at claims data everyday for my job and I would have a hard time knowing the exact codes before I go for a visit. (Also obviously in an emergency I am not shopping around!) And then there are service modifiers for "how long" for CPT codes for just outpatient visits -- you wouldn't be able to know 15/30/60 minutes before hand even if you did know the specific CPT code. So for that you may want to know the proportion the doctor bills, not compare the prices on the same CPT.
- flangola7 3y agoClarifying, encounter means a visit with a provider.