As many of you are aware, October 1, 2015 was a bad day for medical providers. This was the date that ICD-10 went live. I am unhappy with this for more reasons than I can write here, and many in the medical profession share my frustration.

A recent survey by SERMO, a social media site for physicians, reported nearly 86% of 200 respondents were adversely affected by the transition from ICD-9 to ICD-10 (see the accompanying graph¹).

Am I surprised physicians don’t like ICD-10? Of course not. Just by the nature of this being something new that replaces a system that has existed since 1978, it’s predictable that people wouldn’t like the change. Clearly the United States has been resistant to this change for a long time. In fact, most of the rest of the world has been using ICD-10 since 1994.

However, this change seems larger and more potentially difficult than one would like. For me, the first problem is that after around nine years in practice, I had memorized most of the ICD-9 codes pertinent to my practice. ICD-10 is not amenable to easy memorization, so that will add more work to my schedule. Instead of just typing in the diagnostic code into my electronic medical record, I now have to search through a database for the correct code. In an already busy clinic, this adds more time to my overloaded charting.

But wait! The fun keeps coming. ICD-10 is beautifully timed to correspond with all of the new national initiatives such as Meaningful Use. As an employee of a reasonably large group, I’m somewhat protected from the administrative leadership headaches of developing an electronic health system, but for those in individual sole provider practices, I don’t see how this can be anything but a giant nuisance. It’ll be interesting to see how many providers end up closing their practices in favor of becoming an employee to avoid these issues.

I wouldn’t mind this change if I felt it was going to, in some way, improve my patients’ health or my own patient care methods, but other than obtaining more information about diagnostic details, I don’t see this improving anything. How much better will tracking laterality of disease make our medical system? Not much, I’ll wager.

Just to show you how ridiculous some of this is, here’s an image I pulled from the Internet which lists an actual ICD-10 diagnosis code (see image below)². Can you believe there’s an actual code for someone being burned due to his water skis being on fire? How common is this situation? Is it common enough that we need an actual code to describe it?

I was so incredulous that this was true that I looked it up on ICD-10data.com, a website that allows one to look up codes (a highly useful site I might add)³. Here’s a screen shot of the results³ :

Yes, my friends it’s true. It’s an actual legitimate diagnostic code. Thank goodness we finally have a diagnosis for a burn due to water skis on fire. It was just the code I was waiting for. That’s going to improve medical care! But don’t worry, there’s a code for injuries related to macaws (W61.11XA). I know – we’ve been waiting for that one for years.

I actually tried to find the epidemiology of burns due to water skis on fire. I mean, how many incidents can there actually have been? This situation must be too rare to appear on the Internet, so I couldn’t find anything, but if anyone has numbers on this, please clue me in.

This is simply data for data’s sake. Information ad infinitum and ad nauseum. I wish all of my colleagues the best of luck dealing with this idiotic new system. I’ll be there shaking my head right next to you.

We’re going to drown in a sea of useless data. If you don’t like ICD-10, don’t worry; the World Health Organization is currently in the process of developing ICD-11, which will likely be yet more complex. How nice. Something to look forward to.

Best wishes,

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]

1. Pennic F, Frustrated Primary Care Doc Shares 9 Ways ICD-10 Impacted Patient Care. https://hitconsultant.net/2015/10/09/frustrated-primary-care-doc-shares-9-ways-icd-10-impacted-patient-care Last accessed October 11, 2015.
2. Gaspar M, 10 Ways to Make ICD-10 Relatable to ANYONE during #NHITweek. https://blog.himss.org/2014/09/18/10-ways-to-relate-icd10-nhitweek September 18, 2014. Last accessed October 11, 2015.
3. https://www.icd10data.com/ICD10CM/Codes/V00-Y99/V90-V94/V91-/V91.07XD Last accessed October 11, 2015.