There is a point where the need to be so specific translates into some fairly funny ICD-10 codes. We simply can’t avoid citing a few examples: Z63.1 (problems in relationship with in-laws), W61.52XA (struck by goose, initial encounter), and our personal favorite, V91.07XD (burn due to water skis on fire). While quite funny, this level of specificity also brings up a critical question: With so many codes, how does one find the correct one for the diagnosis when seeing a patient?
Thankfully, 21st century tools make the task of locating the appropriate code much simpler than it would have been when ICD-10 was first conceived. Using plain-text search engines such as those from Intelligent Medical Objects, clinicians can be as specific as possible when searching for diagnoses. There are also apps for mobile devices and Web-based tools like ICD10Data.com that are user friendly and completely free. Most importantly, EHR vendors have been anticipating the transition to ICD-10 and have built many of these tools into their products already.
Closing thoughts
We fully acknowledge that this transition to increased specificity may be anxiety provoking, but we are also forced to accept that it is necessary. While it is debatable whether figures like Graunt and Farr are worthy of accolade or ire (though on Oct. 1 most will probably choose the latter), it’s undeniable that there is a need to gather and tabulate statistics on medical diagnoses. That need was first formally addressed well over 300 years before the dawn of electronic health records and will continue to be addressed for hundreds more. In the meantime, we have a code we’d like to propose for ICD-11: E011.13 – anxiety due to heath information technology. Like ICD-10, this is a concept that’s far from new and certainly here to stay.
Dr. Notte is a family physician and clinical informaticist for Abington (Pa.) Memorial Hospital. He is a partner in EHR Practice Consultants, a firm that aids physicians in adopting electronic health records. Dr. Skolnik is associate director of the family medicine residency program at Abington Memorial Hospital and professor of family and community medicine at Temple University in Philadelphia.