Spoiler Alert: ICD-10 Goes to the (Scary) Movies

Posted on 23 Oct, 2018 |comments_icon 0|By Bruce Pegg

Halloween is only a few days away, and is there any better way to celebrate than to curl up on the couch with a bowlful of candy and some scary movies?

Well, if you’re a coding geek like all of us here at TCI, you can add to your fun by getting out your ICD-10 and assigning a code – or sometimes several – to each creepy cinematographic creation.

Take a look and see if you agree with our dire diagnoses of these classic horror stories.

Jaws (1975)

Let’s start with an easy one. Coding this suspenseful thriller about a great white shark with an insatiable appetite for human swimmers is a bit of a no-brainer. You really have only one choice: W56.41XA (Bitten by shark, initial encounter).

Psycho (1960)

Alfred Hitchcock’s classic psychological horror film is famous for its shower scene, the three-minute scream fest in which Janet Leigh’s character, Marion Crane, is hacked to death by psychotic motel owner Norman Bates (Tony Perkins). This time, the diagnosis has to be – cue shrieking violins – X99.1XXA (Assault by knife, initial encounter).

The Shining (1980)

The climax to this adaptation of Stephen King’s ghostly novel features Jack Torrance (Jack Nicholson) running amok and terrorizing his family in an isolated haunted hotel before being lured to a frozen death in the snow. Here, you’ll have to bypass R68.0 (Hypothermia, not associated with low environmental temperature) in favor of T68.XXXA (Hypothermia, initial encounter), being careful to follow the instructions to code the source of the exposure as well, which in this case would be X31.XXXA (Exposure to excessive natural cold, initial encounter).

Arachnophobia (1990)

This Disney black comedy/creature feature centers around a bunch of Amazonian killer spiders that go on a rampage in a small California town. For this one, you really have to go with T63.391A (Toxic effect of venom of other spider, accidental (unintentional), initial encounter).

A Nightmare on Elm Street (1984)

Movies don’t get much scarier, so you’re going to have to assign codes to both the victims and the villain in this one. For the victims, killed when Freddy Krueger invades their dreams, F51.5 (Nightmare disorder) is a pretty good candidate. As for Freddy, who was burned alive by an angry mob, T31.99 (Burns involving 90% or more of body surface with 90% or more third degree burns) is the way to go.

Dracula (1931 and countless times since)

In this timeless tale of Transylvanian terror, your best bet would be to code the newly undead with S11.83XA (Puncture wound without foreign body of other specified part of neck, initial encounter). But spare a thought for the poor old Count, whose nocturnal lifestyle, devoid of daylight, clearly must have led his PCP to a diagnosis of E55.9 (Vitamin D deficiency, unspecified).

Texas Chainsaw Massacre (1974)

Last, and certainly not least, you’ll have to code this legendary gore flick with approximate codes for both slasher and slashees. ICD-10 falls short when it comes to finding death by chainsaw in the tabular list, so the closest code you can assign Leatherface’s victims will be W29.3XXA (Contact with powered garden and outdoor hand tools and machinery, initial encounter). And Leatherface himself? Sadly, instead of cannibalism, you’ll have to go with the less specific … wait for it … F50.8 (Other eating disorders).

Mwahaha! Happy Halloween from all of us at TCI!

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Bruce Pegg
Editor, Newsletters

An experienced teacher and published author, Bruce is TCI’s new voice of primary care, delivering advice and insights every month for coders in the fields of family, internal, and pediatric medicine through Primary Care Coding Alert and Pediatric Coding Alert. Additionally, he is the current editor of E/M Coding Alert. Bruce has a Bachelor of Arts degree from Loughborough University in England and a Master of Arts degree from The College at Brockport, State University of New York. He recently became a Certified Professional Coder (CPC®), credentialed through AAPC.

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