Why there are so many diagnoses in ICD-10-CM

Carl Natale
by Carl Natale

In case you're wondering why there are so many diagnosis codes in ICD-10-CM, consider tinnitus.

Emma Greenwood, founder of Whooshers.com, is an advocate for those with pulsatile tinnitus. It's a different diagnosis from tinnitus:

"We hear a constant and rhythmic whooshing, swooshing, pulsing, pulsating, clicking or other sound that is in sync with our heartbeat. Pulsatile tinnitus is not a condition; it is a symptom of an underlying condition.  The list of possible underlying conditions is long and is not isolated to one medical speciality.

Pulsatile tinnitus is not the same as regular, nonpulsatile tinnitus.  Most of us do NOT hear a ringing sound.  Unlike the 'regular,' more common form of tinnitus, pulsatile tinnitus can sometimes be remedied (some doctors even use the word CURED) when the underlying cause is identified."

Greenwood says the ICD-9-CM code is the same for tinnitus and pulsatile tinnitus, and has started an online petition to create a pulsatile tinnitus diagnosis code in ICD-10-CM.  Here's why:

"Without a diagnosis code, patients with pulsatile tinnitus are being improperly classified as part of the larger tinnitus community, with whom they share few medical similarities, resulting in unnecessarily inadequate medical attention, diagnoses, and treatments. A unique diagnosis code would appropriately address this subset of the tinnitus community, for whom relatively little research and medical advocacy has been devoted."

For Greenwood, having a new diagnosis code can lead to diagnosing life-threatening conditions because pulsatile tinnitus is a symptom of something larger. If she can make her case to the right people, it could be included in a future modification of the ICD-10-CM code set. I'm assuming would include codes for laterality and subsequent encounters.

This isn't the only example of how an ICD code set fails to document every medical diagnosis. ICD-10 critics can find a few examples to illustrate why the ICD-10 codes are inadequate for medicine. For some reason it doesn't occur to them to work have the omissions included in upcoming modifications.

But if they did that, then the growing number of ICD-10-CM codes would become another argument against ICD-10 implementation.