Bit by a duck? The government has a code to bill for that

I used to tell my patients I could either know billing or know medicine, but under the new "reforms" of medicine you have to do it right or not be paid.

So the new codebook coming soon has this:

November 1, 2011 — Physicians have gotten a few laughs from the new and voluminous set of diagnostic codes known as ICD-10, which distinguishes between being struck by a duck (W6162XA) and being bitten by a duck (W6161XA)...

The Centers for Medicare and Medicaid Services (CMS) decreed the switch to ICD-10 in 2009 as part of implementing the Health Insurance Portability and Accountability Act (HIPAA)...

With ICD-10, physicians will be able to document what ails a patient with far more specificity. ICD-9, for example, has a code for a malignant neoplasm of an arm, but ICD-10 offers 3 options: upper right arm, upper left arm, or unspecified arm.

Finally, a Code for Walking Into a Lamppost

Such multiple choices help explain why the new code set is almost 5 times larger than the old one. However, some may wonder whether the authors of ICD-10 got carried away in covering every base.

ICD-9, for example, recognizes that patients may seek treatment because they were bitten, and gives clinicians a few choices, such as dog, rat, snake, arthropod, unspecified animal, or human.

ICD-10, in contrast, is a veritable zoo of bite codes — horse, cow, cat, pig, shark, dolphin, sea lion, alligator, macaw, parrot, and duck, to name just a few new kinds of jaws. And for each kind of bite, physicians can pick a code for an initial encounter, subsequent encounter, or sequela.

ICD-10 also describes the world of bumps and bruises in excruciating detail, with codes for walking into a wall versus a lamppost versus a piece of furniture. Ever been crushed between a sailboat and another kind of water craft? There's a code for that, too — V9114XA.

Some accident codes, however, defy the imagination, such as the famous V9107XA: burn due to water-skis on fire, initial encounter...