Y93.D1: Activity, knitting and crocheting
Knitting is back, and it's popular with more than just your grandmother — even teenagers are picking up needles. If your patient lacks the fine motor skills or functionality required for this hobby, or is a particularly enthusiastic knitter, you may find yourself using this code.
T75.81: Effects of abnormal gravitation [G] forces
Spend any time in space lately? Astronauts experiencing prolonged periods in zero gravity often return home with issues related to osteoporosis.2 NASA's on the case, but until they find a solution, use this code when treating the next Neil Armstrong.
V10.0: Pedal cycle rider injured in collision with pedestrian or animal in nontraffic accident
All physical activity comes with risk, bicycling included. Although physical activity can have a protective effect on rheumatoid arthritis,3 remind your patients to make way for ducklings when out for a ride, or else they might find themselves in the middle of a pedestrian or animal nontraffic accident.
W27.4: Contact with kitchen utensil
Is your patient the next Chopped champion? Maybe not, if pain is affecting their ability to perform activities of daily living. A 2016 population-based cross-sectional study4 of people aged 65 years and older found that participants with musculoskeletal conditions were "significantly more often affected" by these issues than those without diseases such as osteoporosis or osteoarthritis.
Y93.E2: Activity, laundry
As in the previous slide, some patients may struggle with basic housekeeping activities such as laundry, vacuuming (Y93.E3), and floor mopping (Y93.E5). Turns out chores are indeed a hazard to your health.
W56.02XD: Struck by dolphin, subsequent encounter
Studies published in the Journal of Rheumatology,5 the American Journal of Cardiology,6 and the European Journal of Physical and Rehabilitation Medicine7 all indicate that water-based exercise can positively affect osteoarthritis, vascular function, and ankylosing spondylitis, among other conditions — but marine mammals can certainly be hazardous to your health. Be sure to counsel patients on the dangers of striking dolphins, or they'll be back in your office sooner than you think.
Y93.C1: Activity, computer keyboarding
Keeping in touch with friends and family is important, but sometimes we need to step away from social media. Prolonged typing or texting can aggravate already-swollen joints in the hands and fingers, leading to flare-ups or pain. In 2014, the Journal of Orthopedic Case Reports published a study8 of the effect of cell phone use (and abuse) on patients' hand and finger joints.
Z63.1: Problems in relationship with in-laws
The psychosocial effects of pain and arthritis are no laughing matter, much like in-law relationships. If your patients are struggling with familial relationships, consider screening them for depression and anxiety, both of which are comorbidities to rheumatic diseases.9
Y92.253: Opera house as the place of occurrence of the external cause
The social impact of arthritic diseases can take a toll on your patients.10 But once their symptoms are under control,11 encourage them to get out and enjoy some extracurricular activities. For example, opera is a low-impact cultural activity, but remember: patients should beware of phantoms.
V97.33XD: Sucked into a jet engine, subsequent encounter
Safety first, folks.
With nearly 70,000 International Classification of Diseases, 10th Edition (ICD-10) diagnosis codes available to clinicians,1 things are bound to get interesting. The staff at Rheumatology Advisor has compiled a list of 10 unusually specific ICD-10 codes that may leave you scratching your head.
Compiled by Lauren Biscaldi
- National Center for Health Statistics. International Classification of Dieseases (ICD-10-CM/PCS) Transition – Background. Atlanta, GA: Centers for Disease Control and Prevention; 2015. https://www.cdc.gov/nchs/icd/icd10cm_pcs_background.htm. Updated October 1, 2016. Accessed January 24, 2017.
- Preventing bone loss in space flight with prophylactic use of bisphosphonate: health promotion of the elderly by space medicine technology. NASA website. https://www.nasa.gov/mission_pages/station/research/benefits/bone_loss.html. Published February 29, 2012. Accessed January 24, 2017.
- Di Giuseppe D, Bottai M, Askling J, Wolk A. Physical activity and risk of rheumatoid arthritis in women: a population-based prospective study. Arthrit Res Ther. 2015;17:40. doi: 10.1186/s13075-015-0560-2
- Stamm TA, Pieber K, Crevenna R, Dorner TE. Impairment in the activities of daily living in older adults with and without osteoporosis, osteoarthritis, and chronic back pain: a secondary analysis of population-based health survey data. BCM Musculoskelet Disord. 2016;17:139. doi: 10.1186/s12891-016-0994-y
- Alkatan M, Baker JR, Machin DR, et al. Improved function and reduced pain after swimming and cycling training in patients with osteoarthritis. J Rheumatol. 2016;43:666-672. doi: 10.3899/jrheum.151110
- Alkatan M, Machin DR, Baker JR, Akkari AS, Park W, Tanaka H. Effects of swimming and cycling exercise on vascular function in patients with osteoarthritis. Am J Cardiol. 2016;117:141-145. doi: 10.1016/j.amjcard.2015.10.017
- Karapolat H, Eyigor S, Zoghi M, Akkoc Y, Kirazli Y, Keser G. Are swimming or aerobic exercise better than conventional exercise in ankylosing spondylitis patients? A randomized controlled study. Eur J Phys Rehabil Med. 2009;45:449-457.
- Canillas F, Colino A, Menedez P. Cellular phone overuse as a cause for trapeziometacarpal osteoarthritis: a two case report. J Orthop Case Rep. 2014;4:6-8. doi: 10.13107/jcor.2250-0685.213
- Backman CL. Arthritis and pain. Psychosocial aspects in the management of arthritis pain. Arthrit Res Ther. 2006;8:221. doi: 10.1186/ar2083
- Theis KA, Murphy L, Hootman JM, Wilkie R. Social participation restriction among US adults with arthritis: a population-based study using the International Classification of Functioning, Disability, and Health. Arthrit Care Res. 2013;65:1059-1069. doi: 10.1002/acr.21977
- Kavanaugh A, Smolen JS, Emery P, et al. Effect of certolizumab pegol with methotrexate on home and work place productivity and social activities in patients with active rheumatoid arthritis. Arthrit Rheum. 2009;61:1592-1600. doi: 10.1002/art.24828