Coding for Halloween

EDITOR’S NOTE: With Halloween on the radar, ICD10monitor Contributor Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for the St. Louis-based First Class Solutions, Inc.℠, had some lighthearted advice to share about coding certain types of fears and phobias that may just emerge at this time of year.

Coding for Halloween isn’t scary at all. Spiders and spiderwebs are often used as part of Halloween decorating.  They can be cute or spooky. Arachnophobia is a fear of spiders, and would be coded to F40.210. 

If you have hemophobia, or a fear of blood, you probably won’t be watching any horror movies this Halloween. You would code fear of blood to F40.230. Here is another one you may not have heard of – samhainophobia. It is a specific phobia or fear of anything Halloween-related. According to the Cleveland Clinic, many people who experience this have had a past traumatic situation related to Halloween. While we don’t have a specific code for samhainophobia, I would think we could assign F40.298, Other specified phobia.

Porphyria is a rare group of blood disorders that are usually inherited, but some cases can be acquired. All types of this disease involve a problem with hemoglobin production. It is also known as “vampire disease.” While we don’t have a specific index entry for vampire disease, we would assign E80.20 for unspecified porphyria. 

Hypertrichosis is defined as abnormal, excessive hair growth. It is also referred to as “werewolf syndrome.” Like vampire disease, this can be acquired or congenital. It also can be localized to specific parts of the body or generalized. We would assign L68.9 for Hypertrichosis, unspecified. 

Hopefully those horror movies that are so popular around this time of year don’t give you nightmares. While nightmares are not rare, nightmare disorder is. According to Psych Central around 4 percent of adults have nightmare disorder, which is also known as dream anxiety disorder. The code for nightmare disorder is F51.5. 

Sleep terrors are not the same as nightmares. According to the Mayo Clinic, a nightmare is a bad dream that a person may remember some parts of when they wake up. People who have sleep terrors remain asleep during the episode. 

Sleep terrors are more common in children ages 1-12, and fortunately, most outgrow the condition. Sleep terrors are coded to F51.4.

It seems like once the weather starts to get a tiny bit cooler, we start to see pumpkin- and pumpkin spice-flavored everything. If you have an allergy to pumpkin, you would want to stay away from all of these in order to avoid an anaphylactic reaction. We have code T78.04 for anaphylactic reaction due to fruits and vegetables – which would include pumpkin. We would add placeholder X and assign a 7^th character A, D, or S, depending on the episode of care.  Luckily, our code description here notes both fruits and vegetables, so we don’t have to worry about which pumpkin actually is. While there may be some debate on this subject, pumpkin is a fruit. Real Simple noted an easy way to note the difference between fruits and vegetables, which some of you probably already know…fruits have seeds, vegetables do not.

When we think of Halloween, often our first thought is candy. If you have a history of a peanut allergy, you would want to avoid peanut M&Ms, Paydays, Snickers and Mr. Goodbars, to name a few. Allergy to peanuts is coded to Z91.010.

If you are allergic to nuts other than peanuts, you would probably want to avoid Almond Joy and Turtles, among others. Z91.018 is the code for Allergy to other foods, which includes allergy to nuts other than peanuts. Either way, no need to fear, because there are plenty of yummy candies that have no nuts at all.

Allergy or no allergy, make sure you are brushing your teeth after eating all that candy and those pumpkin-flavored treats. We all want to avoid cavities. Category K02 is for those. Codes include specificity, identifying the tooth surface affected as well as an unspecified code option.

We hope everyone has a fun and safe Halloween!