ICD-10 Terminology: Subsequent encounters with a common misunderstanding

Carl Natale
by Carl Natale

I'm sorry if you already know this. But there are a lot of smart people who don't understand a fundamental term in the ICD-10 code set.

I found an example of it in an interview with Silvia Senes, an IT leader for more than 15 years who has tackled ICD-10 transition in Canada. She shared some valuable insights on ICD-10 implementation during the conversation.  But here's how it ended:

Before we close, you and I have joked before about some funny ICD-10 codes. Do you have a favorite one, if only because it's downright goofy?

W59.22XD - Struck by turtle, subsequent encounter

What are the odds of being struck by a turtle, not bitten, and of the encounter to happen more than once?

Yeah funny. My sides hurt (Please don't tell me the ICD-10 code for that.)

Patrick Zummo doesn't think the turtle jokes are very funny. And he tries to disarm turtles as weapons against ICD-10 specificity. Note that Senes doesn't use the turtle as a criticism. She just thinks its' funny. What's wrong with her joke is her understanding of "subsequent encounter." I will let Zummo explain:

"One of the biggest and most significant misconceptions inherent to the implementation of ICD-10 is the confusion that subsequent encounter means that ‘it happened again’. In truth, that designation is meant to describe when the patient has received active treatment for the injury, and the physician is providing routine care for the injury during the healing or recovery phase (hcpro.com)."

Obviously Senes is an intelligent healthcare professional with experience working with ICD-10 code sets. But if she misunderstands a term used throughout the codes, there are plenty of other people doing the same.

Unfortunately they're using that misunderstanding to minimize the validity of the code set.