In October 2015, the United States adopted the ICD-10 medical coding system. Before this change, the U.S. was using an older International Classification of Diseases model called ICD-9. The U.S. had been using the ICD-9 code set since 1979. The switch to ICD-10 marked an important transition in U.S. healthcare.
The ICD-10 code set contains 68,100 more procedure codes and 55,798 more diagnosis codes than the ICD-9 code set. With so many new codes, ICD-10 significantly improved the level of specificity in medical coding. This specificity helps to describe the cause, severity, and bodily location of a certain illness or injury.
Definitive Healthcare’s Medical Claims database allows users to search for ICD-9 and ICD-10 codes. By comparing related diagnosis and procedure codes, users can track changes in medical coding and billing.
One of these changes relates to the expansion of certain niche diagnosis categories like animal-inflicted injuries. Here, we’ll take a look at the most common animal-inflicted injuries within the ICD-10 code set. We've categorized the injuries into those inflicted by venomous and non-venomous animals because treatment for the two injury types is so distinct.
How are ICD-10 codes for animal-inflicted injuries different from ICD-9 codes?
The 2020 edition of the ICD-10 code set contains over 300 diagnoses related to animal-inflicted injuries. These ICD-10 diagnoses offer very specific detail about the type of animal encounter. In the ICD-10 code set, these animal encounters can range from “pecked by turkey” (ICD-10 code W6143XA), to “struck by cow” (ICD-10 code W5522XA), or “crushed by crocodile” (ICD-10 code W5813XA).
The ICD-9 system contained only 20 diagnosis codes for any injury resulting from an animal encounter. In the ICD-9 code set, these diagnosis codes were categorized as either “venomous animals and plants as the cause of poisoning and toxic reactions” (ICD-9 code E905) or, “other injury caused by animals” (ICD-9 code E906). The diagnosis codes themselves were broad and contained none of the same detail that the ICD-10 codes do.
In January 2022, ICD-10 will be replaced by ICD-11. This updated code set offers further improvements to the number of diagnostic terms and their specificity. Each new ICD update allows for more precise data collection and analysis.
What are the most common injuries related to non-venomous animals?
The most common injury related to non-venomous animals is “bitten or stung by non-venomous insect and other non-venomous arthropods, initial encounter” (ICD-10 code W57XXXA). In 2019, physicians in the U.S. submitted 584,676 claims for non-venomous insect bites.
Most common injuries related to non-venomous animals
||Total Number of Diagnoses
||Bitten or stung by non-venomous insect and other non-venomous arthropods, initial encounter
||Bitten by dog, initial encounter
||Bitten by cat, initial encounter
||Bitten by dog, subsequent encounter
||Scratched by cat, initial encounter
||Bitten or stung by non-venomous insect and other non-venomous arthropods, subsequent encounter
||Animal-rider injured by fall from or being thrown from horse in non-collision accident, initial encounter
||Other contact with dog, initial encounter
||Bitten by cat, subsequent encounter
||Bitten or stung by non-venomous insect and other non-venomous arthropods, sequela
Fig 1 Data is from Definitive Healthcare’s Medical Claims database. Represents most common physician diagnoses for animal-related external causes of morbidity. Total number of diagnoses reflects all-payer medical claims from the 2019 claim year, the most recent full-year data available. Commercial claims data is sourced from multiple medical claims clearinghouses in the United States and updated monthly. Accessed October 2020.
The ten animal-inflicted injuries above accounted for 976,858 total diagnoses in 2019. This is a significant number of animal-inflicted injuries. But six of the ten diagnoses are described as “initial encounter.” This means that most of the injuries were not severe enough that patients had to return for subsequent care or treatment.
Subsequent encounters for a diagnosis like “animal-rider injured by fall” could indicate more serious complications.
What are the most common injuries related to venomous animals?
“Toxic effect of venom of bees, accidental, initial encounter” (ICD-10 code T63441A) is the most common injury related to venomous animals. In 2019, physicians in the U.S. submitted 113,645 claims for venomous bee stings.
Most common injuries related to venomous animals
||Total Number of Diagnoses
||Toxic effect of venom of bees, accidental (unintentional), initial encounter
||Toxic effect of venom of wasps, accidental (unintentional), subsequent encounter
||Toxic effect of venom of hornets, accidental (unintentional), subsequent encounter
||Toxic effect of venom of bees, accidental (unintentional), subsequent encounter
||Toxic effect of venom of wasps, accidental (unintentional), initial encounter
||Toxic effect of venom of ants, accidental (unintentional), subsequent encounter
||Toxic effect of venom of other arthropod, accidental (unintentional), initial encounter
||Toxic effect of unspecified spider venom, accidental (unintentional), initial encounter
||Toxic effect of venom of hornets, accidental (unintentional), initial encounter
||Toxic effect of venom of ants, accidental (unintentional), initial encounter
Fig 2 Data is from Definitive Healthcare’s Medical Claims database. Represents most common physician diagnoses for animal-related causes of external injury and poisoning. Total number of diagnoses reflects all-payer medical claims from the 2019 claim year, the most recent full-year data available. Commercial claims data is sourced from multiple medical claims clearinghouses in the United States and updated monthly. Accessed October 2020.
In the table above, there is a notable difference between the ICD-10 codes and their corresponding ICD-9 codes. There are ten unique ICD-10 diagnosis codes, and only two corresponding ICD-9 codes: 9895 and V5889. ICD-9 code 9895 broadly describes the toxic effect of venom, and code V5889 is used for all subsequent encounters to describe “other specified aftercare.”
In comparison, the ICD-10 codes differentiate between the type of insect, the nature of the encounter, and how many times a patient sought care for that injury. The specificity of these codes can be helpful for healthcare organizations targeting a particular patient population.
How do ICD-10 codes improve documentation for animal-related injuries?
Because ICD-10 codes are so specific about illness and injury origin, clinical documentation is much more detailed than it was with the ICD-9 system.
For instance, an accidental injury like “toxic effect of bee venom, accidental” (ICD-10 code T63441A) has a different diagnosis code than a purposeful injury like “toxic effect of bee venom, intentional self-harm” (ICD-10 code T63442A).
With more robust documentation, healthcare providers have a better understanding of their patients’ medical histories. This can improve a physician’s ability to make informed treatment decisions.
Are you interested in learning more about how to use diagnosis and procedure codes? Catch our on-demand webinar: The Definitive Approach to Healthcare Sales 101: Codifying the Patient Journey.
In this presentation, Definitive Healthcare data scientists walk you through the basics about medical claims, including:
- What medical claims are
- Which codes to use when searching claims data, and
- How to use claims data to understand patient journeys
Originally published February 27, 2018