I just “virtually” attended the AOA’s latest ICD-10 webinar. I liked that I could be there without actually being there—I even attended the webinar in my underwear, which created quite a stir at the Starbucks where I logged on.

So began the most absurd 55 minutes of my life. If you know me, it should disturb you greatly that this was my life’s most absurd 55 minutes.

It took the speaker—who was amazing and intelligent about the whole thing—about 15 minutes to describe the best way to code for one diagnosis on one patient with one specific problem. And this is an expert in ICD-10, not some numbskull old-timer like me! To do this right, I’ll have to schedule only one patient a day!

Get Ready for ICD-11
I decided to see if I could find out what’s to come in the next ICD evolution. The good news? The next ICD incarnation addresses the craziness of the ICD-10 system. The bad news? It does so by being so stupid that it makes ICD-10 look like the Good Ol’ Days.

Here’s a quick example:

The patient presented with acute onset eye pain and redness plus blurry vision, which began at the same moment his face collided with a Fulvous Whistling duck while he was hang-gliding in Venezuela.

ICD-9? Easy. It’s 379.91–Eye Pain and 918.1–Corneal Abrasion.

ICD-10? There’s a specific code for it: W61.62XA–Struck by Duck, Initial Encounter. (Really!)

How about ICD-11 on an even easier patient?

Not so easy. Follow along…

A patient presented with light sensitivity OD that started one evening around 7:00 PM and has persisted for one week.
First, open your “British Reference Manual, Volume 1,” and try to find:

• Right eye—not in Latin, you idiot; in Olde English—RYGHT! Use the code “R.”
• When did this start? One enchanted EVENING! Code is “E.”
• What time did this start? 7:00? No, too specific! Use “AROUND” or “ABOUT” 7:00. Code is “A.”
• Light sensitive? Is it spelled “Lyght,” “Plight”(p is silent), “Leight,” “Lahyett”? OK, it’s just “light.” This is easy—just refer to the second reference manual under “Ouchy Things” and you’ll soon find “LIGHT,” which is coded “L.”
• How long has this hung around? Since LAST WEEK? Stick an “L” in there again—not to be confused with the previous “L” which, of course, requires a request for a different font (in this case, Comic Sans) so as to not make the auditors think you mean there are two “Last Weeks” or two “Lights” involved.
• How bad was the pain? Was it bad enough to: Blink, Rub, Wince, Yell, Scream, Wet Pants, Get Drunk or Kill Self? This code must be very specific, so if the patient simultaneously Winced and Wet Himself, then the claim will be denied. So, we’ll just say “YELL,” which is code “Y.”
• Did you answer all the patient’s questions? You have to code that with a “?” modifier.

So, in this case, the ICD-11 code is: “REALLY?”

Yes, really.

On a brighter note, ICD-12 will be much easier because its concept depends on the demise of all health care in the United States by then.

ICD-12 is actually just a bus ticket to see a faith healer in Cabo. One way.