5 ms·

https://twitter.com/NavalInstitute/status/1230542979124822022?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1230542979124822022%7Ctwgr%5Ebbe0b28105a35cd3

https://twitter.com/NavalInstitute/status/1230542979124822022?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1230542979124822022%7Ctwgr%5Ebbe0b28105a35cd3c64e56483ceefd67566eb7b7%7Ctwcon%5Es1_c10&ref_url=https%3A%2F%2Fwww.military.com%2Fhistory%2Fsailor-survived-getting-sucked-jet-engine-during-operation-desert-storm.html https://twitter.com/NavalInstitute/status/123054297912482202... Here's a video of a guy getting sucked into a jet engine and surviving. Most, of course, do die. I don't quite understand why everyone is so bothered by the extensive ICD taxonomy; it clearly needs to be extremely extensive to cover even fairly common scenarios, and once you're past the point that things can be easily managed why not cover everything?

thfuran 3y ago
Sure, it's necessary to have some specificity so that providers and insurance companies can be reasonably informed about what's going on, but this stuff has a very real cost. Healthcare providers have entire departments of people dealing with coding. The more complex it gets, the more time consuming and expensive it is to correctly code things. At some point (I suspect well behind us), the added cost isn't worth the marginal benefit.
- skissane 3y ago
  These codes were originally developed by the World Health Organisation to collect public health statistics, and statistics on causes of death - that’s their original purpose, not insurance billing. A lot of codes which seem silly or pointless for insurance have more validity when keeping their original purpose in mind. There’s an ICD-10 code for executions - Y35.5 - can you bill an execution to health insurance? I hope not, but as a possible value for a cause of death field in a death certificate database, it makes sense.
  - thfuran 3y ago
    Sure, there are other uses for the data. But the fact remains that generating it isn't free. And changing the coding in and of itself incurs significant administrative cost, so "we've come this far; we might a well just keep going" isn't really a compelling reason to expand ICD.
    - skissane 3y ago
      > Sure, there are other uses for the data. But the fact remains that generating it isn't free. And changing the coding in and of itself incurs significant administrative cost, so "we've come this far; we might a well just keep going" isn't really a compelling reason to expand ICD. The WHO expands and revises ICD all the time - and how it gets used by US health insurance isn’t really a concern of theirs. The WHO has 194 member states and the US is only one of them. WHO intends the ICD to be used for collecting public heath and cause of death statistics, and if some countries want to use it for insurance/billing - that’s their problem, not the WHO’s The US uses its own modified version of ICD-10, ICD-10-CM, which adds even more codes. A lot of those added US-specific codes exist simply because some hospital - or bureau of vital statistics - somewhere in the US, was tracking that. Other countries have done the same thing - Australia has the ICD-10-AM, Canada the ICD-10-CA, Germany the ICD-10-GM, etc Just because a code exists doesn’t mean you have to use it for any particular purpose. Indeed, most medical software packages permit disabling codes you don’t want clinicians to be able to use. In an insurance system, a code like Y35.5 is likely marked as non-billable.
      - thfuran 3y ago
        Yes, but we're in a thread about health insurance. That that isn't the primary concern of the WHO is beside the point.
        skissane 3y ago
        Yes, but the ICD isn’t for health insurance, it is for international standardisation of mortality and morbidity statistics, so they can be compared between countries. That’s its purpose and the reason for its existence The fact that the US chooses to use it for something which was not its originally intended purpose is the fault of the US, not the fault of the ICD. The WHO doesn’t force the US health insurance system to use it, the US could invent its own totally unrelated coding system for that purpose and the WHO wouldn’t care (so long as those codes can be converted to ICD codes for statistical analysis)
        3y ago

thfuran 3y ago

Sure, it's necessary to have some specificity so that providers and insurance companies can be reasonably informed about what's going on, but this stuff has a very real cost. Healthcare providers have entire departments of people dealing with coding. The more complex it gets, the more time consuming and expensive it is to correctly code things. At some point (I suspect well behind us), the added cost isn't worth the marginal benefit.

skissane 3y ago
These codes were originally developed by the World Health Organisation to collect public health statistics, and statistics on causes of death - that’s their original purpose, not insurance billing. A lot of codes which seem silly or pointless for insurance have more validity when keeping their original purpose in mind. There’s an ICD-10 code for executions - Y35.5 - can you bill an execution to health insurance? I hope not, but as a possible value for a cause of death field in a death certificate database, it makes sense.
- thfuran 3y ago
  Sure, there are other uses for the data. But the fact remains that generating it isn't free. And changing the coding in and of itself incurs significant administrative cost, so "we've come this far; we might a well just keep going" isn't really a compelling reason to expand ICD.
  - skissane 3y ago
    > Sure, there are other uses for the data. But the fact remains that generating it isn't free. And changing the coding in and of itself incurs significant administrative cost, so "we've come this far; we might a well just keep going" isn't really a compelling reason to expand ICD. The WHO expands and revises ICD all the time - and how it gets used by US health insurance isn’t really a concern of theirs. The WHO has 194 member states and the US is only one of them. WHO intends the ICD to be used for collecting public heath and cause of death statistics, and if some countries want to use it for insurance/billing - that’s their problem, not the WHO’s The US uses its own modified version of ICD-10, ICD-10-CM, which adds even more codes. A lot of those added US-specific codes exist simply because some hospital - or bureau of vital statistics - somewhere in the US, was tracking that. Other countries have done the same thing - Australia has the ICD-10-AM, Canada the ICD-10-CA, Germany the ICD-10-GM, etc Just because a code exists doesn’t mean you have to use it for any particular purpose. Indeed, most medical software packages permit disabling codes you don’t want clinicians to be able to use. In an insurance system, a code like Y35.5 is likely marked as non-billable.
    - thfuran 3y ago
      Yes, but we're in a thread about health insurance. That that isn't the primary concern of the WHO is beside the point.
      - skissane 3y ago
        Yes, but the ICD isn’t for health insurance, it is for international standardisation of mortality and morbidity statistics, so they can be compared between countries. That’s its purpose and the reason for its existence The fact that the US chooses to use it for something which was not its originally intended purpose is the fault of the US, not the fault of the ICD. The WHO doesn’t force the US health insurance system to use it, the US could invent its own totally unrelated coding system for that purpose and the WHO wouldn’t care (so long as those codes can be converted to ICD codes for statistical analysis)
        3y ago