My friend and colleague, Dr. Jack Ostrich, who always gives us an enlightening Christmas Story gave us this one. The ICD 9 would have several codes for different types of fracture, for instance, now the ICD 10 has dozens of codes to identify minor differences and what is the type of visit for each type of fracture. Hence, the humor of his parody.

We’ve always enjoy Jack’s Christmas stories. This year he gave us an adaption from an essay by Gerry Wieder, RN of Seattle

`Twas the night before Christmas, when all through the house,

Not a creature was stirring, not even a mouse.

W53.01XA Bitten by mouse, initial encounter

W53.01XD Bitten by mouse, subsequent encounter

W53.09XA Other contact with mouse, initial encounter

W53.09XD Other contact with mouse, subsequent encounter

The stockings were hung by the chimney with care,

In hopes that St. Nicholas soon would be there.

X06.2XXA Exposure to ignition of other clothing and apparel, initial encounter

X06.2XXD Exposure to ignition of other clothing and apparel, subsequent encounter

X06.3XXA Exposure to melting of other clothing and apparel, initial encounter

X06.3XXD Exposure to melting of other clothing and apparel, subsequent encounter

The moon on the breast of the new-fallen snow

Gave the lustre of mid-day to objects below.

X37.2XXA Blizzard (snow)(ice), initial encounter

X37.2XXD Blizzard (snow)(ice), subsequent encounter

When, what to my wondering eyes should appear,

But a miniature sleigh, and eight tiny reindeer.

201.01 Encounter for examination of eyes and vision with abnormal findings

R44.1 Visual hallucinations

With a little old driver, so lively and quick,

I knew in a moment it must be St. Nick.

R54 Age-related physical debility

F22 Delusional disorders

More rapid than eagles his coursers they came,

And he whistled, and shouted, and called them by name:

R49.8 Other voice and resonance disorders

R49.9 Unspecified voice and resonance disorder

“Now, Dasher! now, Dancer! now, Prancer and Vixen!

On, Comet! on Cupid! on, Donner and Blitzen!

W55.39XA Other contact with other hoof stock, initial encounter

W55.39XD Other contact with other hoof stock, subsequent encounter

To the top of the porch! to the top of the wall!

Now dash away! dash away! dash away all!”

V97.0 Occupant of aircraft injured in other specified air transport accidents

W13.0XXA Fall from, out of or through balcony, initial encounter

W13.0XXD Fall from, out of or through balcony, subsequent encounter

W22.01XA Walked into wall, initial encounter

W22.01XD Walked into wall, subsequent encounter

As dry leaves that before the wild hurricane fly,

When they meet with an obstacle, mount to the sky,

X37.0XXA Hurricane, initial encounter

X37.0XXD Hurricane, subsequent encounter

So up to the house-top the coursers they flew,

With the sleigh full of toys, and St. Nicholas too.

Y93.29 Activity, other involving ice and snow

V96.8XXA Other nonpowered-aircraft accidents injuring occupant, initial encounter

V96.8XXD Other nonpowered-aircraft accidents injuring occupant, subsequent encounter

And then, in a twinkling, I heard on the roof

The prancing and pawing of each little hoof.

W13.2XXA Fall from, out of or through roof, initial encounter

W13.2XXD Fall from, out of or through roof, subsequent encounter

W55.32XA Struck by other hoof stock, initial encounter

W55.32XD Struck by other hoof stock, subsequent encounter

            As I drew in my head, and was turning around,

Down the chimney St. Nicholas came with a bound.

X02.0XXA Exposure to flames in controlled fire in building or structure, initial encounter

X02.0XXD Exposure to flames in controlled fire in building or structure, subsequent encounter

He was dressed all in fur, from his head to his foot,

And his clothes were all tarnished with ashes and soot.

Y93.E9 Activity, other interior property and clothing maintenance

A bundle of toys he had hung on his back,

And he looked like a peddler just opening his pack.

Z59.0 Homelessness

Z59.1 Inadequate housing . . .

He had a broad face and a little round belly,

That shook, when he laughed like a bowlful of jelly.

E66.3 Overweight

Z72.3 Lack of physical exercise . . .

He sprang to his sleigh, to his team gave a whistle,

V00.221A Fall from sled, initial encounter

V00.221D Fall from sled, subsequent encounter

V00.228 Other sled accident

And away they all flew like the down of a thistle.

But I heard him exclaim, ‘ere he drove out of sight,

W94.23XA Exposure to sudden change in air pressure in aircraft during ascent, initial encounter

W94.23XD Exposure to sudden change in air pressure in aircraft during ascent, subsequent

encounter

 “Happy Christmas to all, and to all a good-night.”

Read the RN’s original and complete version at http://gerrywieder.com/an-icd-10-christmas-tale/

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