When among friends or other health information management (HIM) professionals, individuals who spend their working hours coding will readily acknowledge their “detail oriented” tendencies and admit to some degree of perfectionism. A lesser known habit of coding professionals, however, is conversation amongst themselves about their favorite codes—and everyone, it seems, has them.
Journal of AHIMA staff sought to peer inside the psyche of the coding professional by asking “What’s your favorite code and why?” Respondents’ answers at once demonstrated a sense of whimsy, gallows humor, attention to detail, and surprisingly philosophical sentiments.
“I was able to narrow down quickly which code I could use to describe myself to about five to six codes… most of them having to do with something accidentally on fire, such as plastic jewelry, water-skis, pajamas and the like. Asphyxiation in an old refrigerator was a runner-up for a short while, but a few seconds later it dawned on me that that might be just a little too morbid,” said Carolyn Veith, RHIT, coding and billing specialist with Allied Physicians Group. Veith also pointed to a series of codes that she feels reflects of the orderliness of coding professionals. “I’m not sure why, but for some reason I like bones—each one has its own name, structure, etc. It’s really heavy on anatomy but as long as providers document properly (sorry, I had to say it), it’s actually not that hard. ICD-10-CM has a pretty specific selection of codes when it comes to coding fracture locations and types, which makes it much easier to match up the code with what the provider describes in the medical record.”
While there are many bizarre ICD-10 codes to choose from, such as “burn due to water skis on fire” (Y93.D: V91.07XD) or “struck by a macaw, initial encounter” (W61.12XA), you might be surprised to learn that these odd codes are not always considered coding favorites.
Read the following slideshow and see if you can find your own coding soulmate amongst some of AHIMA’s most passionate coding experts.
“I like to code obstetrical delivery and newborn records because it is a happy event and it’s fun to see how old the mother is, how big is the baby, and what name was selected for the baby. Some of the baby names are interesting! It is also fun to code the moms who are admitted after the baby is born at home, in the car on the side of the road, or in the parking lot, in the ambulance—what were they waiting for to come to the hospital? Always good stories there.” —Lou Ann Schraffenberger, MBA, RHIA, CCS, CCS-P, FAHIMA, manager of clinical data, Center for Health Information Services, Advocate Healthcare
“My favorite type of encounter to code is a moving or compelling patient success story. Every so often, as a coder, you get the privilege of coding a chart for a patient that beats the odds and overcomes a catastrophic illness or traumatic injury. As you’re reviewing the documentation to assign the correct codes as well as looking for any necessary provider query opportunities, you also find yourself a bit invested in the patient narrative, especially in pediatrics. An added bonus is when the interventions required may be unfamiliar to you and requires some clinical research on your part or a deeper dive into published coding guidelines and advice to ensure you’ve captured it correctly.” —Amy Czahor RHIT, CDIP, CCS, vice president, optimization and analytics services, RecordsOne
“Just because of the code–HZ2ZZZZ. We call it the sleeper code. We get a chuckle to assign the substance abuse detoxification code every time.” —Lou Ann Schraffenberger, MBA, RHIA, CCS, CCS-P, FAHIMA, manager of clinical data, Center for Health Information Services, Advocate Healthcare
“Back when I was coding full time, my favorite types of cases to code were coronary artery bypass graft (CABG) surgeries. I worked at a large acute care hospital that did a lot of open heart surgeries and we saw these cases a lot, so I got very proficient at coding them. The reason I liked to code these was that the surgeons always included a diagram of the heart that showed the areas of blockage and the types and numbers of bypass grafts used. It was helpful to have the drawing of what was done, along with the narrative description of the procedure in the operative report to fully understand what the procedure entailed.” —Melanie Endicott, MBA/HCM, RHIA, CDIP, CHDA, CPHI, CCS, CCS-P, FAHIMA, interim vice president, HIM practice excellence, AHIMA
“W34.011A—Accidental discharge of paintball gun, initial encounter. Here’s why: First off, I love paintballing. It’s an awesome, fun way to play and exercise with your friends. Plus, it’s pretty fun to shoot paintballs at people. But as I got to thinking about this code, it seemed more metaphorical to how life goes when you really have a passion for something, but [are] not really sure how to express it. Sometimes you splatter paint everywhere and it’s an absolute mess, but it’s okay because at the end of the day you can wash it off. Sometimes it’s absolute art on the first shot. Sometimes you end up splattering paint where you’re not supposed to, or when you’re not supposed to—hence the accidental discharge.” —Carolyn Veith, RHIT, coding and billing specialist, Allied Physicians Group
“I25.110—CAD with unstable angina. This is a favorite because it resolves the sequencing issue we’ve always struggled with in ICD-9—which to code first, the CAD or the angina. With this combination code, that struggle is over. Also, V97.33—person sucked into aircraft jet. I’ve always loved this external cause code. While it would be horrible for the victim, I would love to use that code! —Kathy DeVault, MSL, RHIA, CCS, CCS-P, FAHIMA, manager, HIM consulting, UASI