Different Personal Injury Medical Codes

When you go to the doctor, your personal injury diagnosis is identified by a medical code. They are known to be very complicated- there are over 3,000 ICD codes to describe various physical injuries. There’s a different five digit code for every medical injury from a broken leg to an insect bite.

In the past year, nearly every 1 out of 6 people in the database were diagnosed with a physical injury. From this statistic, we thought it would be interesting to take a closer look at the figures and data.

To make things easier, we grouped some of the injuries together- like “bruising” instead of 38 different kinds of confusion. From there, we then looked at every health insurance data point from 2012-2016. To learn more about our methodology read on.

The Most Common Injuries in the US

Due to a lot of different cases, one injury cannot consist of more than 7-8% of all the injury diagnoses. Although, from our findings, we still found that the concentration of injuries varies from state to state.

“Bruising” or “open wound” is the most common injury in all states except Colorado- “falls” are at the top of the list. Bruises and cuts are the most common injury that people endure throughout all states.

But we wanted to know what makes each state unique?

A Unique Injury in Each State

To figure this out correctly, we compared the percentage of every injury in every state to the national average. This allowed us to find what injuries stood out more than others.

Here is an example: Motorcycle injuries make up 1.5% of all physical injuries in the United States. But Tennessee takes the cake with a whopping 2.5%— that is 1.6 times more than the national average!

Some broad trends stand out a lot more than usual such as “suffocation,” which was in six of the eight Mountain states: New Mexico, Idaho, Nevada, Utah, Wyoming, and Colorado. The Physical Injury diagnose "suffocation" was 1.8 times more common in Idaho compared to the national average, and 3.1 times more prevalent in Utah. The other four mountain states fell somewhere in the middle of the two numbers.

Unfortunately, we are not sure why this occurs. But most of the “suffocation” diagnoses were for hypoxemia, which is a medical term for low blood oxygen. Interestingly, hypoxemia can be caused by too much exertion at high altitudes. This is where the supply of oxygen is scarce. There is no proven evidence of why this occurs, but it is interesting that it does occur in all of the mountain states.

Other statistics were impressive as well, such as the vast amount of concussions in Massachusetts. According to a 2016 report from Blue Cross Blue Shield, concussions rates have been increasing significantly in the United States due to the amount of awareness being brought to the topic. Massachusetts also had the highest rate of youth concussions in 2015.

Medical Codes in the West

For this analysis, we focused more on the injuries that accounted for at least 1% of physical injury diagnoses in each state. That way we saw injuries that stood out more.

If you change the standard to 0.1% (thus including extremely different injuries), some things are prominent:

• “Near-drowning” diagnoses are 6.2 times more prevalent in Hawaii than any other state. This is justified due to it being the only state that is entirely covered by water. It also corresponds to Hawaii’s other data.
• “Animal-drawn vehicle accident” diagnoses, which includes people falling off of animals, are prevalent in these five states: Idaho, Montana, Wyoming, North Dakota, and Nebraska. Crazy enough, there were about 43,000 animal-drawn vehicle accidents in our national data from 2012 to 2016. More than 1,000 of these accidents happened in Nebraska alone.
• “Unarmed fight or brawl” is very common in New York. There were 295,797 “unarmed fights ” medical diagnoses in our national database. 35,000 of those unarmed fights occurred in New York alone. That means New York accounts for more than 10% of documented (medically) fist fights.

Methodology

There are over 3,000 ICD-9 codes that are related to physical injuries (broken bones, sprains, scrapes, cuts, bruises, etc.). We grouped these codes together into 170 different group sets. (Where applicable, we mapped ICD-10 codes to ICD-9 codes to keep things more consistent).

Our first step was to assess all the health insurance claims from 2012 to 2016 that includes the codes in the 170 total codes. The data set results included 244,000,000 claims. Then, we split up these claims nationally and from state to state. Lastly, we compared the state ratios to the national ratios to show us which are more standard in each state relative to the nation as a whole.

Keep this in mind: we are looking at health insurance claims as the doctors that diagnosed the physical injury. This makes our results not entirely accurate because doctor’s practices vary immensely. Some doctors may code some physical injuries as a whole different code than a different state. Due to inconsistent data, the results are a direct streamline of information from doctors and insurance companies.

In conclusion, similar codes get grouped in one category, which further reinforces the idea that we’re observing coding behavior every day.

If you have experienced a personal injury, The Law Offices of Alvin De Levie can help you! Our dedicated team of attorneys will help you with your case. If you would like to learn more or receive a free consultation for your case, contact us at 844-777-2529.