Top 13 Missing ICD-10 Codes

The ICD-10 code set is scheduled for implementation by October 1, 2013. ICD-10 (CM+PCS) contains 140,000 or so codes, far greater than the 18,000 that comprise the outgoing ICD-9 code set. A recent Wall Street Journal article described the granularity of  the new code set and provided examples of ICD-10 codes that will strike the average healthcare professional as odd such as:

  • V91.07XA: Burn due to water-skis on fire, initial encounter
  • W22.02XA:  Walked into lamppost, initial encounter
  • W22.02XD: Walked into lamppost, subsequent encounter
  • R46.1: Bizarre personal appearance
  • R46.0: Very low level of personal hygiene
  • W5921XA: Bitten by turtle, initial encounter
  • W5922XA: Struck by turtle, initial encounter

Later in the article, a CDC official explains why the code set  includes so many terms for apparently uncommon injuries.

Medicare and CDC officials say codes were selected based on years of input from medical experts in various fields. Codes describing the circumstances of injuries are important for public-health researchers to track how people get hurt and try to prevent injuries, they say.

Being able to tabulate risks tied to locations such as chicken coops could be ‘important as far as surveillance activities’ for public health research, says Donna Pickett, a medical systems administrator at the CDC. (1)

As an informatics professional, especially one interested in the semantics of clinical data, I applaud the lengths to which the CDC and CMS have gone in order to assure that we have granular data for clinical research.   Unlike others, I have no intention of making fun of the codes.  Instead, I will concentrate on learning them expertly.  To that end, I have found a few codes that I do not fully comprehend and need additional clarification.  For example, I understand the value of codes that describe animal-related injuries.  So “bitten by a turtle” makes perfectly good sense to me. However, I need help with “W5922XD: Struck by turtle, subsequent encounter.”   Is this code describing the criminal misuse of turtles; the actions of impertinent, high-minded turtles with anger management issues; or attacks by mutant ninja turtles? (If there is someplace in the world where saying the wrong thing to a turtle can get you in serious trouble, I need to know.)

The only downside that I see with ICD-10 is the absence of codes for injuries and ailments that I encountered in my years of clinical practice. As a public service, and to increase the expressiveness of ICD-10, I offer the following codes to CDC and CMS.

Missing ICD-10 Codes

13.    R4.444:  Benign proliferative addressomania,  elevated sense of importance secondary to having more than three  email addresses

12.    W657.01X:  Kissed by a frog

11.    S67.oYF:  Extremity crush injury, hungry, hungry hippo, initial encounter

10.   M2334:  Facial gunshot wound,  high-ranking federal official, hunting encounter

9.      R46.12X:  Bizarre personal appearance, zero fashion sense, sequela

8.      W344.02:  Jived by a turkey, initial encounter

7.    B678.3:  Running with scissors

6.      W4567-90:  Facial burn, Acme TNT, Roadrunner, seemingly every encounter

5.      A113.0B:  “it”

4.      S01.7RB:  Head injury, Colonel Mustard, initial encounter (pipe, in library)

3.      W542.03Z:  Schmoozed by a turtle, multiple encounters

2.     W542.02XA:  A guy walks into a bar…

1.     L23.0WS:  Cooties



  1. AM Matthews. Walked Into a Lamppost? Hurt While Crocheting? Help Is on the Way. Wall Street Journal, September 13, 2011. Accessed October 16, 2011.




  1. It’s so nice to see health care providers with such an appreciation for ICD10…LOL!!! I think “Cooties” is my favorite.

  2. There should be an ICD-10 code along the lines of “nervous stomach and dry mouth, encounter with uber intelligent and intimidating professor”. 🙂

    1. Do you actually know of someone who suffered with this unfortunate malady?

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