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February 14, 2017; 88 (7) Reflections: Neurology and the Humanities

“Alligators All Around” and the ICD-10 code set

Alan D. Legatt
First published February 13, 2017, DOI: https://doi.org/10.1212/WNL.0000000000003602
Alan D. Legatt
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“Alligators All Around” and the ICD-10 code set
Alan D. Legatt
Neurology Feb 2017, 88 (7) 716-717; DOI: 10.1212/WNL.0000000000003602

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With the changeover from ICD-9 to ICD-10 codes has come a tremendous expansion in the number of diagnosis codes, from 14,025 to 69,823,1 covering an amazing number of conditions. One newspaper story I read pointed out that there are codes for being bitten by an alligator and for being sucked into a jet engine. I investigated further,2 and found out that there are actually 12 separate codes for encounters with an alligator (table 1). It is surprising that there are not separate codes for alligator-related injuries to the left vs the right side of the body, given the ICD-10 penchant for identifying laterality whenever possible (and even when it is not possible—there are separate codes for aneurysmal subarachnoid hemorrhage from the “left anterior communicating artery,” I60.22, from the “right anterior communicating artery,” I60.21, and from an “unspecified anterior communicating artery,” I60.20).

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Table 1

Codes for encounters with an alligator

Obviously, this is a situation that is ripe for parody. My wife, Elizabeth, also a physician, commented that “bitten by alligator” made her think of “Alligators All Around,” a Carole King song which we fondly remember listening to and singing with our children when they were young (they are all now grown up and married). The two of us can still sing it today, mostly from memory. Her comment prompted me to do some searching of the ICD-10 codes,2 and I managed to find codes that were (more or less) appropriate for all 26 lines of “Alligators All Around.” The results are shown in table 2. Those wishing to listen to Carole King singing “Alligators All Around” can find it on YouTube or download an mp3 file.

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Table 2

Codes that are (more or less) appropriate for all 26 lines of “Alligators All Around”

ACKNOWLEDGMENT

“Alligators All Around.” Words and music by Carole King and Maurice Sendak. Copyright © 1975 Colgems-EMI Music Inc. and Elorac Music, Inc. Copyright renewed. All rights administered by Sony/ATV Music Publishing LLC, 424 Church Street, Suite 1200, Nashville, TN 37219. International copyright secured, all rights reserved. Reprinted by permission of the Hal Leonard Corporation.

Footnotes

  • Listen to Dr. Legatt read this essay, available on the iPad® and Android™ devices.

  • © 2017 American Academy of Neurology

REFERENCES

  1. 1.↵
    Centers for Disease Control and Prevention. International Classification of Diseases (ICD-10-CM/PCS), transition: background. Available at: cdc.gov/nchs/icd/icd10cm_pcs_background.htm. Accessed November 6, 2015.
  2. 2.↵
    ICD10Data.com. Available at: icd10data.com/. Accessed November 6, 2015.
View Abstract

Disputes & Debates: Rapid online correspondence

  • ICD-10 code set-making a case for keeping it simple and straight forward
    • Nitin K. Sethi, Associate Professor of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center, New Yorksethinitinmd@hotmail.com
    Submitted April 04, 2017
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