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

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).

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.

• © 2017 American Academy of Neurology