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MEMPHIS, TENNESSEE    The aftermath of a chest gunshot wound treated in Emergency Room 1 at the Elvis Presley Memorial Trauma Center in Memphis, Tennessee. Memphis paramedic Patricia Artella, from the ambulance radio communications room, says "Have you ever seen them crack a chest? It's like a hog slaughter; blood on the walls, blood on the ceiling, half inch thick on the floor..."  (Photo by Zed Nelson)

A TTAG tipster emails:

Robert, I have attached below the list of ICD-10 codes relating to “diagnosis codes” containing the word “firearm.” These codes will be required to be reported by fed.gov on all health services claims forms effective October 1. As you can see, they would primarily be reported by emergency departments when they treat a gunshot wound. I cannot find any definition for the code words, such as “military firearm” or “larger firearm.” No use of the term “negligent” discharge. Some of them are really interesting, such as “Legal intervention involving discharge of unspecified firearm, bystander injured, subsequent encounter.” Actually that means follow-up treatment for the GSW, but it still has an interesting alternative meaning . . .

ICD-10 Code ICD-10 Code Description

W33.00XA Accidental discharge of unspecified larger firearm, initial encounter
W33.00XD Accidental discharge of unspecified larger firearm, subsequent encounter
W33.00XS Accidental discharge of unspecified larger firearm, sequela
W33.09XA Accidental discharge of other larger firearm, initial encounter
W33.09XD Accidental discharge of other larger firearm, subsequent encounter
W33.09XS Accidental discharge of other larger firearm, sequela
W33.10XA Accidental malfunction of unspecified larger firearm, initial encounter
W33.10XD Accidental malfunction of unspecified larger firearm, subsequent encounter
W33.10XS Accidental malfunction of unspecified larger firearm, sequela
W33.19XA Accidental malfunction of other larger firearm, initial encounter
W33.19XD Accidental malfunction of other larger firearm, subsequent encounter
W33.19XS Accidental malfunction of other larger firearm, sequela
W34.00XA Accidental discharge from unspecified firearms or gun, initial encounter
W34.00XD Accidental discharge from unspecified firearms or gun, subsequent encounter
W34.00XS Accidental discharge from unspecified firearms or gun, sequela
W34.09XA Accidental discharge from other specified firearms, initial encounter
W34.09XD Accidental discharge from other specified firearms, subsequent encounter
W34.09XS Accidental discharge from other specified firearms, sequela
W34.10XA Accidental malfunction from unspecified firearms or gun, initial encounter
W34.10XD Accidental malfunction from unspecified firearms or gun, subsequent encounter
W34.10XS Accidental malfunction from unspecified firearms or gun, sequela
W34.19XA Accidental malfunction from other specified firearms, initial encounter
W34.19XD Accidental malfunction from other specified firearms, subsequent encounter
W34.19XS Accidental malfunction from other specified firearms, sequela
X73.8XXA Intentional self-harm by other larger firearm discharge, initial encounter
X73.8XXD Intentional self-harm by other larger firearm discharge, subsequent encounter
X73.8XXS Intentional self-harm by other larger firearm discharge, sequela
X73.9XXA Intentional self-harm by unspecified larger firearm discharge, initial encounter
X73.9XXD Intentional self-harm by unspecified larger firearm discharge, subsequent encounter
X73.9XXS Intentional self-harm by unspecified larger firearm discharge, sequela
X74.8XXA Intentional self-harm by other firearm discharge, initial encounter
X74.8XXD Intentional self-harm by other firearm discharge, subsequent encounter
X74.8XXS Intentional self-harm by other firearm discharge, sequela
X74.9XXA Intentional self-harm by unspecified firearm discharge, initial encounter
X74.9XXD Intentional self-harm by unspecified firearm discharge, subsequent encounter
X74.9XXS Intentional self-harm by unspecified firearm discharge, sequela
X94.8XXA Assault by other larger firearm discharge, initial encounter
X94.8XXD Assault by other larger firearm discharge, subsequent encounter
X94.8XXS Assault by other larger firearm discharge, sequela
X94.9XXA Assault by unspecified larger firearm discharge, initial encounter
X94.9XXD Assault by unspecified larger firearm discharge, subsequent encounter
X94.9XXS Assault by unspecified larger firearm discharge, sequela
X95.8XXA Assault by other firearm discharge, initial encounter
X95.8XXD Assault by other firearm discharge, subsequent encounter
X95.8XXS Assault by other firearm discharge, sequela
X95.9XXA Assault by unspecified firearm discharge, initial encounter
X95.9XXD Assault by unspecified firearm discharge, subsequent encounter
X95.9XXS Assault by unspecified firearm discharge, sequela
Y23.2XXA Military firearm discharge, undetermined intent, initial encounter
Y23.2XXD Military firearm discharge, undetermined intent, subsequent encounter
Y23.2XXS Military firearm discharge, undetermined intent, sequela
Y23.8XXA Other larger firearm discharge, undetermined intent, initial encounter
Y23.8XXD Other larger firearm discharge, undetermined intent, subsequent encounter
Y23.8XXS Other larger firearm discharge, undetermined intent, sequela
Y23.9XXA Unspecified larger firearm discharge, undetermined intent, initial encounter
Y23.9XXD Unspecified larger firearm discharge, undetermined intent, subsequent encounter
Y23.9XXS Unspecified larger firearm discharge, undetermined intent, sequela
Y24.8XXA Other firearm discharge, undetermined intent, initial encounter
Y24.8XXD Other firearm discharge, undetermined intent, subsequent encounter
Y24.8XXS Other firearm discharge, undetermined intent, sequela
Y24.9XXA Unspecified firearm discharge, undetermined intent, initial encounter
Y24.9XXD Unspecified firearm discharge, undetermined intent, subsequent encounter
Y24.9XXS Unspecified firearm discharge, undetermined intent, sequela
Y35.001A Legal intervention involving unspecified firearm discharge, law enforcement official injured, initial encounter
Y35.001D Legal intervention involving unspecified firearm discharge, law enforcement official injured, subsequent encounter
Y35.001S Legal intervention involving unspecified firearm discharge, law enforcement official injured, sequela
Y35.002A Legal intervention involving unspecified firearm discharge, bystander injured, initial encounter
Y35.002D Legal intervention involving unspecified firearm discharge, bystander injured, subsequent encounter
Y35.002S Legal intervention involving unspecified firearm discharge, bystander injured, sequela
Y35.003A Legal intervention involving unspecified firearm discharge, suspect injured, initial encounter
Y35.003D Legal intervention involving unspecified firearm discharge, suspect injured, subsequent encounter
Y35.003S Legal intervention involving unspecified firearm discharge, suspect injured, sequela
Y35.091A Legal intervention involving other firearm discharge, law enforcement official injured, initial encounter
Y35.091D Legal intervention involving other firearm discharge, law enforcement official injured, subsequent encounter
Y35.091S Legal intervention involving other firearm discharge, law enforcement official injured, sequela
Y35.092A Legal intervention involving other firearm discharge, bystander injured, initial encounter
Y35.092D Legal intervention involving other firearm discharge, bystander injured, subsequent encounter
Y35.092S Legal intervention involving other firearm discharge, bystander injured, sequela
Y35.093A Legal intervention involving other firearm discharge, suspect injured, initial encounter
Y35.093D Legal intervention involving other firearm discharge, suspect injured, subsequent encounter
Y35.093S Legal intervention involving other firearm discharge, suspect injured, sequela
Y36.420A War operations involving firearms pellets, military personnel, initial encounter
Y36.420D War operations involving firearms pellets, military personnel, subsequent encounter
Y36.420S War operations involving firearms pellets, military personnel, sequela
Y36.421A War operations involving firearms pellets, civilian, initial encounter
Y36.421D War operations involving firearms pellets, civilian, subsequent encounter
Y36.421S War operations involving firearms pellets, civilian, sequela
Y36.430A War operations involving other firearms discharge, military personnel, initial encounter
Y36.430D War operations involving other firearms discharge, military personnel, subsequent encounter
Y36.430S War operations involving other firearms discharge, military personnel, sequela
Y36.431A War operations involving other firearms discharge, civilian, initial encounter
Y36.431D War operations involving other firearms discharge, civilian, subsequent encounter
Y36.431S War operations involving other firearms discharge, civilian, sequela
Y37.420A Military operations involving firearms pellets, military personnel, initial encounter
Y37.420D Military operations involving firearms pellets, military personnel, subsequent encounter
Y37.420S Military operations involving firearms pellets, military personnel, sequela
Y37.421A Military operations involving firearms pellets, civilian, initial encounter
Y37.421D Military operations involving firearms pellets, civilian, subsequent encounter
Y37.421S Military operations involving firearms pellets, civilian, sequela
Y37.430A Military operations involving other firearms discharge, military personnel, initial encounter
Y37.430D Military operations involving other firearms discharge, military personnel, subsequent encounter
Y37.430S Military operations involving other firearms discharge, military personnel, sequela
Y37.431A Military operations involving other firearms discharge, civilian, initial encounter
Y37.431D Military operations involving other firearms discharge, civilian, subsequent encounter
Y37.431S Military operations involving other firearms discharge, civilian, sequela
Y38.4X1A Terrorism involving firearms, public safety official injured, initial encounter
Y38.4X1D Terrorism involving firearms, public safety official injured, subsequent encounter
Y38.4X1S Terrorism involving firearms, public safety official injured, sequela
Y38.4X2A Terrorism involving firearms, civilian injured, initial encounter
Y38.4X2D Terrorism involving firearms, civilian injured, subsequent encounter
Y38.4X2S Terrorism involving firearms, civilian injured, sequela
Y38.4X3A Terrorism involving firearms, terrorist injured, initial encounter
Y38.4X3D Terrorism involving firearms, terrorist injured, subsequent encounter
Y38.4X3S Terrorism involving firearms, terrorist injured, sequela

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66 COMMENTS

  1. Don’t forget

    V95.41XA Spacecraft crash injuring occupant, initial encounter

    They’ve outdone themselves with ICD-10. I can’t wait.

      • They’ve got to be trolling us.

        I think I will put some of these codes in my charting just to see if UM is paying attention.

        • You know I remember reading the ships emergency signal code in the coast guard and I thought they had everydamn thing in there. ‘Captain has a tooth ache, requires a glass of milk’ stuff like that.

          I didn’t see anything about burning water skis though

      • I have been billing ICD 9 codes for eye care insurance claims for twenty years , there have been additions and changes over this time span but a complete overhaul is insane and yet it has arrived right along with Barry Care .
        My productivity and the countries productivity will go down while all this crap gets worked into the fabric of the new healthcare norms but eventually it may be finically beneficial to the entire industry because ,
        ( if done correctly ) i.e. using new computer software , that will cost hundreds and thousands of dollars , the new codes allow to billing for specifics , which means , more reimbursements’ . In most cases the savings won’t be seen for years however , because of the initial investment needed for the new software .
        My practice will most likely lose out , along with thousands of others like mine , that choose to ignore the trends and continue to do it the old fashion ways . Ink pen , HCFA form and a copy of the new codes in a notebook in my desk . I will go with fairly new technology and use a highlighter marker to highlight the codes that we bill most often .
        What a F– ‘ed up world it’s evolved into . Stupidity rules the day . Insurance should be for catastrophic incidences and people should pay for general healthcare from their bank accounts ( CASH ) . We should elect people who will take our country backwards to a time when people saved money and invested in land ownership instead of an economy based on consumerism and spending and living in condos and cracker box neighborhoods .
        It could be done if we changed the taxing system to consumer taxes rather than income taxes . The conservative saver would be rewarded and the obsessive spender would have to pay for their lifestyle and the people living on the backs of the worker would have to pay the same tax as EVERYONE .
        We would lower the deficits , reducing foreign borrowing , quell greatly all inflation , reduce or eliminate healthcare inflation , strengthen local banking , incentivize saving which would eliminate much government welfare , collecting income from black market trades because everyone would be required to pay for consumption , the very wealthy would lose their tax loopholes and the more lavish they lived the more they would be paying in and the government could subsidize the catastrophic healthcare cost so no one would have to worry about losing their life’s savings because they got the big C and I wouldn’t have to study up on 150 pages of new healthcare codes for the eye care industry at the age of 57 .

        • Screw consumption taxes (along with any activity based taxes that require government spying on people. Tax real estate to fund local gov, tariffs to fund feds), but otherwise good…

          The question isn’t really so much that the government is doing wrong. That’s definitional. But rather, is there still enough backbone in decent people to distance themselves from it all, and stop pretending the scum is in any way representative of some mythical “us.” They’re not. And specifically, they are less so than any possible God Fearing Guy With Guns, regardless of how “different” said latter may seem.

  2. I have to wonder who decides on which code is used, it doesn’t seem to me that a medical practitioner should make the decision of wether it was negle…”accidental”, assault, malfunction, or self inflicted. That would ultimately be up to the police after an investigation which includes the medical report wouldn’t it?

      • In the larger context, this fake “everything has a code” (fake because we know there is no way to have a code for *everything*) it opens the door for all sorts of sanctions/charges/accusations of fraud when somebody has a boo-boo from a piece of space debris that falls through their roof, initial encounter, while tea was boiling on the stove and Celebrity Apprentice was on the TV … but the only codes show that Walking Dead was on the TV … that’s close enough … then an audit shows it happened when WD wasn’t on any cable show and a review of the recorder shows that copies of CA in fact being watched at the time. 15 years for “free healthcare” fraud for you! 😀 And Dr loses their license…

    • And forget about it being an accurate choice. Also, the whole insurance fiasco in this country has its influence in the selection.

    • Yes, now it also does not cover the case where the victim is armed and shoots criminal any different than an assault where the criminal shoots the victim. Did I miss something?

      • Because the people who write these codes believe that shooting someone in self defense is a crime. And it WILL probably come up in someone’s trial.

  3. I work for a software company that is helping medical offices implement ICD-10. The project manager works with me. I think I need to have some fun with a few of these as we do company wide briefings about the codes and implementation.

  4. Perhaps some ID-10T codes? It would be really interesting to see if some “honest” statistics about firearms related injury could come out of this. It’ll probably be distorted anyways.

  5. I work in a medical office(psychiatric), the social workers suggest codes and the doctor has to make the decision which code for diagnosis as the diagnosis is ultimately up to him. Some of the codes are crap, but some of them can make a huge difference in how the insurance companies reimburse for services, and a huge difference for some patients as far as their follow up care.

      • It’s county run… Theoretical the SW are master level with credentials in therapy, and can suggest diagnosing, I being a nurse, I is illegal for me to give a diagnosis as it is out of my scope of practice.

    • They screw those codes up plenty. Or at least I had a doctors office do that a couple of times and list me as schizo :O 😀 It wasn’t until two doctors appointments with a specialist did I just flat out ask “Is there a reason you are treating me with gloves (no pun intended) and hesitant?”. I guess my firearms related shirt and apparel and apparent normal behavior freaked the doc out until I explained their must have been an error. Really scary that something like that could get reported without me even knowing if I was in some system. I check the paperwork on everything now, I used to only give everything a quick glance but now I double check the codes because at one point they looked different every appointment!

    • Nothing with the word Trauma. As soon as you mention trauma, the caregivers will be wanting to provide Trauma Focused Therapy, because it is evidence based, and they can get reimbursed. This will give you a diagnosis of mental illness and disqualified for future purchases.

  6. The codes are used primarily for billing. I got reamed for measuring my patients wounds. The docs would document all wounds as greater than 6 inches. The person who coded charts never saw the patients. All wounds coded as greater than 6 inches got higher reimbursement from insurance. Unless the nursing notes conflicted with the doctors notes, then there was no payment. The coder would teach the docs the best ways to chart for maximum payment. The goobermint requires all medical facilities to go to digital medical records, making it easy to transfer codes.

    • Wow, as a nurse I couldn’t imagine not documenting a wound, or even drawing it into my notes. Recently(2 years ago) before leaving the hospital, we had a clear plastic sterile page we played over any wound and traced with marker.

  7. The level of detail of these codes is idiotic, but this is what happens when Google and The Government get together.

    Google is behind this push because they want to be able to data mine EVERYTHING, and they convinced the government that easier review of medical records will allow for better health studies. No more annoying studies with questionnaires, all they’ll do is set some filters for the data already collected.

    • For two seconds I thought to write this off as a silly conspiracy theory, but on the third second I decided that you’re probably on to something here.

      • I work in healthcare ( eye care ) and it’s funny to watch progressivism move forward .
        A few years ago , all I needed was a persons name , address and phone number to do a simple eye examination .

        If you wanted me to carry your balances for extended eye care , contact fittings , eyeglasses etc. and for me send you a bill every month I did require you to provide me information I could use to turn your account over to collections should you decide not to pay me every month ( S.S. # , D.O.B. , D.L. # etc. ) since I was acting as a lender basically , providing you a product I have paid for and allowing you to pay on time .

        Now , along comes HIPPA rules with requirements that I gather tons if unrelated info on you .
        I am required to inform you of the HIPPA rules , nearly no one ever reads .
        Post the rules where you can read them .
        Secure a file room where I now have to keep this info .
        Add disclaimers to all my fax cover pages .
        Have other doctors offices sign disclaimers before transferring any info via any form of transfer .
        Maintain and operate a shredding machine .
        Waivers are no longer legal in court .
        I have to keep a record of all your medications on file , most people are totally over medicated today .
        I was informed that the proverbial questions would be added shortly to the standardized information forms .
        ( which I will refuse to include no matter what my repercussions ) …………….
        …………………and all this stuff is now in my possession which forces me to add expensive anti hacking soft wear and security to my office and it’s original intent was to protect peoples security . WOW !
        How bright is that . I just wanted to help people see better .

  8. “Larger firearm”… Does that mean bigger than “small arms”? Like a howitzer? 60mm mortar?

    The big question is… can the Fed gov mine this data (meta or otherwise) after it is in “the system”?

  9. I used to work in medical arena. These codes may well be a reflection of the ACA and Murthy. Usually it’s for figuring out insurance reimbursement but my guess is in this case it is about creating data. Glad I’m not involved directly.

    • ICD-10 has been around since the early 90s, although it hasn’t been implemented in the US yet because ICD-9 works fine. The drop dead date for ICD-10 implementation is I believe 1 October.

      • You nailed it cigardog ,
        All this intrusion is actually about ONE WORLD GOVERNMENT , from these new codes to the new 911 address changes , it’s about gathering information on EVERYONE and recording it for the NWO .

  10. The point is , and this has been noted before on CDC injury data but buried, the CDC reported firearm injury are mostly DUPLICATES. Sequela and subsequent both refer to follow up visits.

  11. The lack of cooperation from state, county and city law enforcement agencies will no longer be an impediment to gathering data on the use and misuse of firearms by police officers, criminals and private citizens.

  12. VD. 666 ASAP

    SATAN’s condom broke during a_ _ -rape of entire DNC convention, unsuccessful morning after pill application, male and female pregnancies progressing at alarming rate.

  13. Yes. Though their ICD-10 codes are new, they are just replacing a previous set of coding that is similar. Yes, EVERYTHING has a specific diagnostic code for billing and statistical anslysis. A couple of years ago one of our nurses got out of her car at Lakeside Mall. She had parked near a small grassy area where some geese had nested. They took offense to her proximity to their nest and one ran up and bit her on their leg. This quickly became infected and she was admitted to their Trauma Service due to this animal bite. If you searched the diagnostic codes, there was a diagnostic code for a goose bite. If I remember correctly, it was even specific for the extremity! When I had to add diagnostic codes for billing while covering trauma, I was AMAZED at their number of potential codes, and then level of related reimbursement, that was related to their variances in these codes. Don’t jump on the conspiracy bandwagon. You should see the number of specific diagnostic codes for auto-related injuries!

    • I don’t go to my local Lake side, (in Sterling Heights) it is a GFZ, if I need to go to a mall I go to Great Lakes, with bass pro, it is not a gfz.

    • So curious, is anyone in the know able to check the difference in reimbursement for discharge versus malfunction?

  14. Just like tobaco is taxed thru the roof to partly recover some of the cancer expeneses non insured smokers have one can assume some genius lawmakers will try to tax the hell out of ammo for all the uninsured gunshot victims. 15$ box of 9mm ammo goes to 21$ etc. Never say never.

    • You’re getting into conspiracy theory stuff here. This is mostly a reimbursement issue, and a lesser reason of statistical analysis. Every time I do a procedure I need to enter a diagnosis, and any pertinent secondary diagnoses, in order to justify reimbursement. This is less about guns than it is about the added complexity of the Affordable Care Act (ACA). There are more codes for automobile related injuries than there are for firearms, and they also have to be reported in the same way. Don’t make more of this than there is. Look up something as simple as a saw or hammer and you will also find dozens of related diagnosis codes.

      • True enuff, however consider this 8 years ago who would have guesed that 10 plus round mags would be banned in some states or that one would be required by federal law to purchase medical insurance of face tax penaltys. All Im saying is when it comes to liberal antis theres no such thing as below the belt.

      • It really boils down to one CRAZY fact . There are methods now , in 2015 , of collecting ALL this information on every earthling and organizations in every nation on the planet that are doing it .
        WHAT WILL TRUMP DO WITH ALL THIS INFORMATION ?

  15. Here’s an idea – give an invoice for time and materials to the patient. Just like every other legitimate workman. Cut out the guberment, insurance co, processors etc etc and the invoice will be similar to a procedure at the local veterinary office or auto repair shop.

  16. Fine example of what’s wrong with government. The only purpose to collect this data is to create laws, establish policy and deny payments.

    What useful purpose do these codes service?

    • The purpose they serve is that they look at events and lend statistical significance to them. This is where they come up with data like “68% of people that are thrown from a motor vehicle in an accident are killed.” If you don’t have the statistics, it’s a guess. It can also note a trend showing, as an example, that heroin overdoses are increasing or that drunk driving is decreasing. Just before I left full time EMS I chaired a committee that designed a new county EMS report form. I wanted the form to be user friendly, simple, and yet leave enough space to write a narrative yo tell the story of what happened in the incident. I also had in the back of my mind that this form needed to be simple to gather data from in order to study survival rates from various causes, seat belt use and related injuries, pediatric trauma data…. From what I understand, it met these goals. This is the purpose of these codes, as well as accurately reporting diagnoses for reimbursement. If you want to know how many goose bites there are in the United States each year, and even how many of these get infected, you can pull this data up easily.

  17. So, the would-be robber / rapist winged by their would-be victim gets classified as some kind of “gun violence?” A little help, please? Looking through these codes:

    1 – There seems to be a lot of “how it happened” vs. “what happened.

    2 – In re: “how it happened”, where do legit defensive gun uses go?

    3 – It’s an interesting data set that contains *what happened* but not *what was prevented.*

    So as a thought experiment, consider if my sainted mother wings the thug-du-jour at her door, rather than get pistol-whipped, shot, or worse herself. It seems to me that this would code as a gun violence thing, when I think it’s a net gain. (Assuming for sake of argument that thug-guy intended to, and would have succeeded at doing violence to my mother.) So, he gets shot, which is Bad Gun Violence(tm), while the broken hip and brain injury that *didn’t* land my mother in a painful, limited, shorter rest of her life than had she not get whacked, gets coded … where?

    Anybody getting shot is bad. I think it matters who got shot and why, and true wisdom includes being able to choose between evils.

    As a process comment, any before the fact classification scheme reflects the understandings and yes, biases of the folks who created it. Data-derived classification schemes do that less, and produce new knowledge. It’s called “Knowledge Discovery in Databases”, KDD.

    So, I’d be curious what *data-driven* clusterings and associations motivated this scheme.

    Of course, were one wearing a tinfoil hat, one might speculate that the *skew* in this classification scheme is a feature, not a bug. Given that inconvenient defensive gun use and homicide data from law enforcement, they need another pile of “data.” Once you know how you want it to come out, it’s so much easier to get the data. (First draw the curve. Then plot the data. We learned this in school, did we not?)

    • You obviously have not taken the time to read any number of informed and thoughtful comments that point out how ill-informed, inflammatory and misleading this article is before you wrote your response. Please take 10 minutes and read some of the comments here. You will learn that this is one of a series of periodic updates that code illnesses and injuries, and how they came about. Though I am NO fan of Obama or his administration, this is about billing codes and statistics. Any other interpretation is “conspiracy theory” bullshit. Please take the time to read before shooting from the hip.

  18. ALL conspiracy theories are TRUE , everyone of them . I know this because I am living in a cave in upstate Washington 220 miles from civilization with a family of sasquatch and my best friend E.P. and I were actually abducted by ET’s that survived the Roswell crash . My initials are JFK and I am not permitted to say anything more at this time .

  19. These code descriptors are for the most part not new – the codes themselves are new since we are transitioning to I-10 from I-9. we have always had codes describing the types of injuries, how they occurred and where it happened (although I will say I-10 is more specific!) this has nothing to do with the government tracking info on firearms, nothing to do with Obamacare and nothing to do with anyone getting any more money. the I-10 classification (developed by the World Health Organization) was adopted over a decade ago by every other country EXCEPT the United States. In fact, other countries are gearing up for I-11, and we haven’t even gotten around to the 10 yet here. the delay has been nothing short of a nightmare for those of us in the coding profession.

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