12/14/2015    Edwin Oghoorian, DPM

Outrageous ICD-10 Code of the Day

I have been reading these "outrageous" ICD-10
codes and laughing about it like everyone else
until yesterday when a patient came into my
office complaining of foot pain after being
attacked by a pig. The x-ray showed that the
patient had a displaced fracture of the 5th
metatarsal. Now we all know that every fracture
is caused by some trauma. So when a patient
presents with a fracture are we suppose to google
the proper ICD-10 code to bill based on the cause
of the injury? That's so insane and stupid which
rises a few questions.

1) if we have to use the proper code to show the
cause of the injury then what's the point of
having all the codes for a fracture of any bone?
2) does the treatment of a displaced 5th
metatarsal fracture change if it was from a
prison pool injury or attacked by a pig? I can
see specifying if an infection is caused by a
bacteria or fungus or virus, which does change
the treatment plan. But makes no sense to
specify a cause of an injury which has no impact
on the treatment protocol.
3) if we do nail debridement and use the
diagnosis of "pain in foot" instead of "pain in
toes" will this result in us having to pay the
money back for lack of specificity?
4) the geniuses who came up with the codes didn't
think people may have B/L pain and include that
in the list as well?
5) am I the only one seeing a year from now all
of us writing big checks to insurance companies
because we didn't specify the cause of the
fracture that we treated? Or didn't specify if
the ankle sprain was due to football injury or
basketball injury?
6) why not deny the claim initially with the
comment "code specificity" and allow us to
resubmit correctly rather than wait a year later
to ask for the money back when we can't correct
and resubmit the claim?

Edwin Oghoorian, DPM, San Dimas CA

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