Comments about technological history, system fractures, and human resilience from James R. Chiles, the author of Inviting Disaster: Lessons from the Edge of Technology (HarperBusiness 2001; paperback 2002) and The God Machine: From Boomerangs to Black Hawks, the Story of the Helicopter (Random House, 2007, paperback 2008)

Monday, March 4, 2013

ICD-10 Medical Codes: All the modern mishaps

 It would be a rare person who didn't find something to squeam about (meaning, to act squeamish) when looking over the "ICD-10-CM External Causes of Injuries List" mentioned in this PBS blog.

It's a list for use by those who keep medical records, effective 2014. Some very obscure accidents are coded in ICD-10, like burns from flaming water-skis (see category V91.07) or injuries due to accidental contact with non-poisonous frogs.  We're told ICD-10 makes some medical people squeamish about the extra time it will take to find the right codes next year, compared to today's shorter list.

If you'd like to know more, from here's a draft list of externally-caused injuries, as of late 2012, and here's an addendum with updates.
While I support the idea of cataloguing the full range of threats, the list still needs some work. For one, I didn't see a category for burns due to high-oxygen atmospheres. (While the list offers many entries for flammable materials, high-oxygen settings allow stuff to catch fire that normally aren't very flammable but will burn in pure oxygen.) Nor did I see a category covering projectile injuries due to unsecured metal objects near very high magnetic fields.

But in general the list is spine-chillingly thorough, covering hundreds of contingencies that have not yet sent hordes to the emergency room. Such as:
  • Spacecraft crashing into each other, causing injury to spacemen and spacewomen: V95.43
  • Injuries due to nuclear weapons in armed conflict, aka World War III: Y37.50 through Y37.59
  • Injury following contact with flying horses: W31.81 *
  • Immersion in cryogenic liquids: W93.11
  • Injuries due to falling out of an airplane, eg from an airliner at cruise altitude: V97.0 **

* This isn't the danger of being struck by a falling, antique Mobil Oil sign. Apparently it refers to a broader category of accidents in amusement park rides, because W31.81 also covers bumper-car-related injuries.

** A few such lucky people have made it to the ER, so I suppose a code is needed. One flight attendant survived after falling 33,000 feet from a DC-9 in 1972. I mention a couple of cases in Inviting Disaster. 


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