A turkey is a large bird, one species commonly known as the wild turkey is native to the North American continent, while the domestic turkey is a descendant of this species.
I have never encountered coding for being assaulted by a turkey using ICD 10 in Malaysia. This morning I was amused to find out from a blog that a US legislator, Rep. Ted Poe (R-Texas) was fully aware of the array of ICD 10 codes available for the following conditions, especially the codes available for being assaulted by a turkey:
- Nine codes for being assaulted by a turkey, one code for being assaulted by a turkey for the first time, one code for being assaulted by the turkey a second time etc.
- Five codes for being hit in the face by a basketball; and
- Three codes for being injured by walking into a lamppost.
Poe highlighted these codes in his recent speech when he had criticised the forthcoming ICD 10 medical coding mandate in the US by October 2014. He believes that the level of such detail required for ICD 10 coding “a bit silly”, and would pose challenges for US health care providers.
A check using ICD 10 does not provide codes for the above external cause of injury(s), with such specificity.
But such specificity is provided for in ICD-10-CM.
For example, encounters with a turkey (not necessarily the same turkey) is classified to nine codes, one for “contact with turkey”, one code for “struck by turkey” which has three other codes under this code that describe this diagnosis in greater detail, and one code for “pecked by turkey” which has three other codes under this code that describe this diagnosis in greater detail.
But this is not the same as I think as Poe comprehended based upon his remarks, meaning nine codes assigned for nine encounters of one patient, each of these nine codes assigned for assault by turkey multiple times by one same turkey or different turkeys!
I think it would be absolutely absurd if a patient were to present at a hospital with nine encounters, one after another encounter as a result of assault by a turkey or turkeys, right?
If a patient was struck by a turkey in Malaysia, how would I code to ICD 10. Malaysia does not use ICD-10-CM.
One has to examine Volume 3 of ICD 10 first, to make “clever” (not implying anything here, perhaps “trained” is a better choice of word) decisions in order to assign a near accurate code using ICD 10, unlike my pal in the US using ICD-10-CM. I say “clever” because, you need to find what term(s) define the external cause of injury, which means narrowing down the choice of adjectives defining the lead term(s) for the external cause of injury to search for in Volume 3. I think a good command of the English language is absolutely necessary.
If the doctor had written “struck by turkey” then it would be easy to turn to Section II, Volume 3 and search for the lead term “struck”. Otherwise it is like finding a needle in a hay-stack, searching for the right lead term to look under.
While medical records documentation is not near the desirable quality to expect in most instances, experience in ICD coding will ease this burden when one had encountered such coding problems. However, Health Information Management (HIM) / Medical Records (MR) practitioners still need to examine the entire medical record to find clues to assign an appropriate ICD-10 code in such instances, or simply get back to the attending doctor for help and advice.
So an amateur coder would look under “contact”, and/or “hit” (which asks to “see Struck by”), and/or “exposure”. If you look under (i) “contact”, you will find “contact with animal NEC” and the code W64.-., (ii) “hit”, you will find that you are redirected to go to “see Struck by”, and if you look under (iii) “exposure”, there is no find.
So you just go to “struck” for (ii) above or from “hit” to “struck” and your find “animal (not ridden) NEC and the code W55.-
Since birds are also animals like mammals, reptiles, fish and insects, then the turkey is an animal.
So the code is either W55- OR W64.-.
Checking Volume 1, W55.- states the code as “Bitten or struck by other mammals” while W64.- states the code as “exposure to other and unspecified animate mechanical forces”.
A turkey is a bird and not a mammal, so W55.- is not appropriate already, and I am left with W64.- only.
A turkey which strikes a patient must have been agitated, be it either a wild or a domesticated one ( I can only visualise a domesticated turkey in Malaysia, like those bread for poultry at Jitra, Kedah, Malaysia or a patient raring turkeys at his or her home).
So if the turkey strikes at the patient, then it runs towards the patient with mechanical forces using its legs. Thus, its movement is animated, and mechanical, and I would choose to assign the ICD 10 code W64.-, in this case of a patient exposed to a turkey attack or assault which runs towards the patient with animated motion using the mechanical forces of its legs.
From this example it is clear that ICD 10 is not as specific as ICD-10-CM. That is why ICD 11 is on the way which I think will be more granular that ICD 10.
References:
- Badriyah Turkey Farm, viewed 15 April 2013, < http://badriyahturkeyfarm.blogspot.com/ >
- ICD10Data.com, viewed 15 April 2013, < http://www.icd10data.com/Search.aspx?search=turkey&codebook=AllCodes >
- Kasperowicz, P, Floor Action Blog, The Hill, viewed 15 April 2013, < http://thehill.com/blogs/floor-action/house/292961-lawmaker-rejects-medical-code-mandate-mocks-nine-codes-for-being-assaulted-by-a-turkey >
