Insurance billing codes for injuries resulting from spacecraft

Jon Keegan, a designer for, tweeted at me today: "You will dig some of the crazy medicare codes in our searchable database. Injuries from collision in space." Jon, you are correct.


  1. I find it a little bit more than a SLIGHT bit suspicious that everything is described in terms of “encounters” eh?  I think this is the DEFINITIVE proof of ETs we’ve been looking for!

  2. These are not “Medicare” billing codes. They are ICD-10 codes, known as the
    International Statistical Classification of Diseases and Related Health Problems. A V code is not even used in billing – it is only a classification used internally or in reporting accidents to help describe the cause of an injury.

    1. Agree. But the fact that ICD10 has code is even more insidious!  The ICD 10 standard is used by all interfaces to communicated information about medical issues between systems.  That the ICD 10 committee thought it appropriate to include these codes for use *between* systems and not just in their top secret Area 52 database is…instructive.

      1. Well, what do you do if a spacecraft crashes somewhere and injures people on the ground? Better be prepared…

        The ICD is a nice idea though not as “international” as its name suggests. Individual countries (implementation is often mandated by governments) often flesh out certain chapters, remap or omit them altogether. Best case, it’s consistent within a country (if used correctly by medical professionals, and that’s a big if). At least until a new version comes around and a multi-year transition process is started…

    2. My mother is an EMT in upstate New York and was furious when they rolled this out for required reporting. No attention was paid to making this usable for daily practitioners. It now takes hours to file a report using the system that includes these ICD-10 codes. 

  3. OK, there is a code for injuries sustained while knitting or crocheting, but nothing for “stapler”. Seriously?

  4. V9615XA – Hang-glider explosion injuring occupant, initial encounter / V9107XA – Burn due to water-skis on fire, initial encounter

    I was disappointed that I couldn’t find any involving pirates.

  5. Focusing on the crazy stuff in ICD-10 is fun, but there is a deeper issue here. The basic philosophy of American Medicine is “proceduralism”, the notion that healthcare should be delivered and compensated in terms of a series of procedures. Procedures require justification. Both procedures, and the justifications have medical ontologies. These are CPT, which is maintained as a monopoly by the American Medical Association and ICD, which is actually the more reasonable of the two standards. These -are- Medicare codes in the sense that the federal government mandates the use of these ontologies in billing not only for Medicare/Medicaid, but for all medical billing transactions. This is mandated in the less-famous part of HIPAA. Under the power given in that law, Health and Human Services is mandating the shift between the relatively sparse ICD-9 and ICD-10. Given that most doctors do not actually understand the nuances of ICD-9, the shift will be traumatic.These codes -are not- mandated for all healthcare data transactions, just for all billing transactions. Health information exchange for other purposes should always use SNOMED or another reasonable clinical ontology. I co-authored the first book on Health IT for O’Reilly, and I spent a considerable time detailing the how the issue of codes specifically, and medical billing generally strangles much of the potential of health IT.  For those that are interested in the real details behind this strange story, I submit my shameless plug:

    1. To be fair, most doctors hand over their charts to coding specialists who DO know (or are at least supposed to know) the nuances of these codes. The specialists are the ones who are having to go through retraining on a much larger set of codes that has little connection to the old system.

      1. In theory atleast you are correct. For GP use, you have ICPC-2 (international classification of primary care) classifications. ICD-10 are for specialist use.

        1. What I know of this comes from a friend who’s a coder who worked in a hospital.He took is job very seriously and got certified in ICD-10 and as an ICD-10 trainer. He’s got job security for a long time to come.

  6. This implies dribbling I think…

    W2105XA Struck by basketball, initial encounter
    W2105XD Struck by basketball, subsequent encounter

  7. Yeah you have to get really bored in clinic to start paging through ICD-9 and -10 codes. Although it is a source of amusement. For what it’s worth, I know 3 ICD-9 codes by memory: 793.1, 786.2, and 786.05. Guess my speciality.

     I love this one: V9733XDSucked into jet engine, subsequent encounter

    1. Hm, I shudder to think what you do with a drinking glass on a table; methinks you might have the concepts of certain, ahem, liquid receptacles reversed if you put your mouth near a urinal ;-).

    2. What about the time I chipped my back tooth on the bathroom urinal?

      I think that’s classified as V-TM-Fucking-I

  8. Are Colonial Marines covered from accidentally alien egg laying in the gut? Or is it better to just leave them behind and nuke the facility from orbit? Please get back to Bishop on the Sulaco ASAP. TIA!

  9. Strange.  For aircraft you’ll find stuff like: W9423XA: Exposure to sudden change in air pressure in aircraft during ascent, initial encounter but nothing like that for spacecraft.

  10. There’s also a whole section dedicated to Laser and Energy Weapon related injuries, at least in the ICD-9.  The military may have phased out laser beams with the new ICD-10.

  11. What’s so “crazy” about this stuff? Astronauts have been hurt and killed on spacecraft in our lifetimes. They have insurance plans.

  12. S3801XA Crushing injury of penis, initial encounter
    S3801XD Crushing injury of penis, subsequent encounter

    You really think someone would be more careful with what’s left after the first time…

    1. Sometimes, a crushing injury of the penis is so severe that it cannot be cleared up in just one visit to the doctor. Followup visits are coded as “subsequent encounters”

    1. What are you trying to say here?
      That Roller coasters are perfectly safe?
      That an unsafe roller coaster could not possibly be associated with particular types of trauma, such as falls or heart attacks?

  13. “Inadequate social skills, not elsewhere classified”
    My only comment in this one is: LOL

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