An ICD-10 Tale: Twas the Night Before Christmas

In the true spirit of the holidays, I am sharing an ICD-10 coding gift that was given to me in hopes that you will enjoy it as much as I did. Thank you, Annie Boynton, BS, CPC, COC (formerly CPC-H), CPC-P, CPC-I, RHIT, CCS, CCS-P, CPhT. Your clever mind, generosity, and humility have no limits.

Twas the Night Before Christmas

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‘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
W53.01XS Bitten by mouse, sequela

W53.09XA Other contact with mouse, initial encounter
W53.09XD Other contact with mouse, subsequent encounter
W53.09XS Other contact with mouse, sequela

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
X06.2XXS Exposure to ignition of other clothing and apparel, sequela

X06.3XXA Exposure to melting of other clothing and apparel, initial encounter
X06.3XXD Exposure to melting of other clothing and apparel, subsequent encounter
X06.3XXS Exposure to melting of other clothing and apparel, sequela
W93.2XXS Prolonged exposure in deep freeze unit or refrigerator, sequela

When out on the lawn there arose such a clatter,
I sprang from the bed to see what was the matter.

W42.9XXA Exposure to other noise, initial encounter
W42.9XXD Exposure to other noise, subsequent encounter
W42.9XXS Exposure to other noise, sequela

W06.XXXA Fall from bed, initial encounter
W06.XXXD Fall from bed, subsequent encounter
W06.XXXS Fall from bed, sequela

Away to the window I flew like a flash,
Tore open the shutters and threw up the sash.

W13.4XXA Fall from, out of or through window, initial encounter
W13.4XXD Fall from, out of or through window, subsequent encounter
W13.4XXS Fall from, out of or through window, sequela

The moon on the breast of the new-fallen snow,
Gave the lustre of mid-day to objects below,

Y93.H1 Activity, digging, shoveling and raking

X37.2XXA Blizzard (snow)(ice), initial encounter
X37.2XXD Blizzard (snow)(ice), subsequent encounter
X37.2XXS Blizzard (snow)(ice), sequela

When, what to my wondering eyes should appear,
But a miniature sleigh, and eight tiny reindeer,

Z01.01 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, Donder and Blitzen!

W55.39XA Other contact with other hoof stock, initial encounter
W55.39XD Other contact with other hoof stock, subsequent encounter
W55.39XS Other contact with other hoof stock, sequela

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
W13.0XXS Fall from, out of or through balcony, sequela

W22.01XA Walked into wall, initial encounter
W22.01XD Walked into wall, subsequent encounter
W22.01XS Walked into wall, sequela

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
X37.0XXS Hurricane, sequela

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
V96.8XXS Other nonpowered-aircraft accidents injuring occupant, sequela

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 

W55.32XA    Struck by other hoof stock, initial encounter  
W55.32XD    Struck by other hoof stock, subsequent encounter  
W55.32XS    Struck by other hoof stock, sequela 

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 (fireplace), initial encounter
X02.0XXD Exposure to flames in controlled fire in building or structure (fireplace), subsequent encounter
X02.0XXS Exposure to flames in controlled fire in building or structure (fireplace), sequela

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 flung on his back,
And he looked like a peddler just opening his pack.

Z59.0    Homelessness  
Z59.1    Inadequate housing

His eyes — how they twinkled! His dimples how merry!
His cheeks were like roses, his nose like a cherry!

L71.8 Other rosacea
L71.9 Rosacea, unspecified

And the beard of his chin was as white as the snow;
His droll little mouth was drawn up like a bow,

L67.1 Variations in hair color
L67.8 Other hair color and hair shaft abnormalities
L67.9 Hair color and hair shaft abnormality, unspecified

The stump of a pipe he held tight in his teeth,
And the smoke it encircled his head like a wreath;

Z72.0 Tobacco use

Z57.31 Occupational exposure to environmental tobacco smoke

F17.290 Nicotine dependence, other tobacco product, uncomplicated
F17.291 Nicotine dependence, other tobacco product, in remission
F17.293 Nicotine dependence, other tobacco product, with withdrawal
F17.298 Nicotine dependence, other tobacco product, with other nicotine-induced disorders
F17.299 Nicotine dependence, other tobacco product, with unspecified nicotine-induced disorders

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 was chubby and plump, a right jolly old elf,
And I laughed when I saw him, in spite of myself;

R29.890 Loss of height

E66.09 Other obesity due to excess calories

A wink of his eye and a twist of his head,
Soon gave me to know I had nothing to dread;

H02.043 Spastic entropion of right eye, unspecified eyelid
H02.046 Spastic entropion of left eye, unspecified eyelid
H02.049 Spastic entropion of unspecified eye, unspecified eyelid

H02.143 Spastic ectropion of right eye, unspecified eyelid
H02.146 Spastic ectropion of left eye, unspecified eyelid
H02.149 Spastic ectropion of unspecified eye, unspecified eyelid 

He spoke not a word, but went straight to his work,
And filled all the stockings; then turned with a jerk,

R49.1 Aphonia (Loss of Speech)

Z56.5 Uncongenial work environment
Z56.3 Stressful work schedule
Z56.6 Other physical and mental strain related to work

G47.26 Circadian rhythm sleep disorder, shift work type

And laying his finger aside of his nose,
And giving a nod, up the chimney he rose;
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
V00.221S Fall from sled, sequela
V00.228 Other sled accident

V00.228A Other sled accident, initial encounter
V00.228D Other sled accident, subsequent encounter
V00.228S Other sled accident, sequela

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
W94.23XS Exposure to sudden change in air pressure in aircraft during ascent, sequela

W94.29XA Exposure to other rapid changes in air pressure during ascent, initial encounter
W94.29XD Exposure to other rapid changes in air pressure during ascent, subsequent encounter
W94.29XS Exposure to other rapid changes in air pressure during ascent, sequela

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