Y07.53 ICD-10 DIAGNOSTIC CODE FOR COACH PERPETRATOR OF CHILD AND ADULT ATHLETE ABUSE

ICD stands for the International Classification of Diseases. ICD-10 replaces ICD-9 and is effective Oct.1, 2015. International means worldwide, of course.

• The transition from ICD-9 to ICD-10 is huge, as it reflects a five-fold increase in diagnosis codes, to roughly 69,000 codes.
•IDC-10 codes will contain critical information about epidemiology, health management, and treatment of all conditions.
• Health care professionals use ICD codes to record and identify health conditions.
• Public health workers, legal officials and researchers can use the records and reports of ICD-10 codes to find statistical trends in health, track the causes and outcomes of morbidity (disease) and causes of mortality (death) and statistical and data mining.
• Insurers use ICD codes to classify conditions and determine reimbursement.
• Transitioning to ICD-10 is required by anyone covered by the Health Insurance Portability Accountability Act (HIPAA)—this includes doctors, hospitals and health insurance companies, all of whom rely on these codes for diagnosing patients and billing for services.

• Direct written reports by all Doctors and Health Care Personnel about Child and Adult Athlete Abuse Syndrome, in follow-up to telephone reports to CPS, DCBS, County Attorneys, should include ICD-10 codes for the diagnoses, treatments and perpetrators.
• All Doctors and Health Care Personnel are mandated reporters for all forms of Abuse by federal and state laws.
• Including the Coach Perpetrator Code Y07.53 to ICD-10 codes makes the legal relationship of the Coach to the Athlete “crystal clear” for all the entities in crisis, who have ignored Sports, aboandoned Coaches and everyone involuntarily ignorant, who formerly believed “sports were nations unto their own, without outside interference by the justice system”[Condoleezza Rice], heretofore addressed by the U.S. Surgeon General 2005.
• Legally, the Coach is a “temporary substitute caregiver” to Child Athletes as defined by the ICD-10 codes and has responsibility for the health and welfare of Adult Athletes, who are included in the newly revised abuse codes.

Examples:
Diagnosis: Child Sexual Abuse: ICD-10 Diagnostic Code = T74.22XA
Add the Coach modifier code: ICD-10 Coach Perpetrator Code = Y07.53

Diagnosis: Child physical abuse, confirmed, initial encounter = T74.12XA
Add the Coach modifier code: ICD-10 Coach Perpetrator Code = Y07.53

Diagnosis: Heat exhaustion, anhydrotic, water deprivation initial encounter = Code T67.3XXA
Add the Coach modifier code: ICD-10 Coach Perpetrator Code = Y07.53
________________________________________________________________________________________________________________________________________________________________
When all hell, pandemics, morbidity and mortality break loose, government and other authorities look to Doctors and healthcare personnel to fix the problems before the inevitable like the Plague of Justinian, Smallpox, Ebola and more recently in sports, Concussions, break-out of control. Dr. Robert Cantu and others have timely and expertly addressed the Concussion issues, thankfully.

At the beginning of the 20th Century, President Teddy Roosevelt was shocked by the increase in football-related deaths and casualties. “Roosevelt recognized that the game would have to be changed in order to be preserved. On October 9, 1905 Roosevelt convened a football summit at the White House.” Many attended including coaches, athletic directors, doctors and others. In March 1906, 62 institutions became charter members of the Intercollegiate Athletic Association of the United States (IAAUS) (to be renamed the National Collegiate Athletic Association, NCAA, in 1910). [Score One for Roosevelt, “Football is on trial,” by Karen Abbott, smithsonian.com Sept 20, 2011]

Doctors were very influential for college football’s destiny. “In the January 1906 edition of the Boston Medical and Surgical Journal, Drs. Nichols and Smith published their study, “The Physical Aspect of American Football” based upon their observations of injuries to Harvard players during the 1905 season. Soon, IAAUS began overhauling the rules of the sport, jump-starting football’s evolution toward its modern form.” [T. R. AND FOOTBALL REFORM by Mark Benson, College Football Historical Society,VOL. XVI, NO. III May, 2003]

Sports, Recreation and Exercise* accidental injuries are one issue, but caused or created, preventable, not accidental injuries are another. Sports, Recreation and Exercise* are not above the Law. College Football and all SRE* are not a closed societes, resistant to outside intervention, when crimes perpetrated against Athletes occur. Amateur Football and all SRE are not impervious to the Rules of Law. “Football is not a kingdom unto its own,” said Former Secretary of State Condoleezza Rice. No one is above the law. [Former U.S. Secretary of State, Condoleezza Rice, Regarding the Penn State Tragedy, on CNN State of the Nation, Candy Crowley Nov 20, 2011].

As a result of the epidemic of preventable, not accidental injuries caused or created by Coaches, Y07.53 IS THE NEW ICD-10 DIAGNOSIC CODE FOR COACH PERPETRATOR OF CHILD AND ADULT ATHLETE ABUSE. This is the American ICD-10-CM version. Other countries might have different codes for the same incidents and modifiers.

2015 ICD-10-CM Diagnosis Code Y07.53 is “Applicable To the Coach, perpetrator of maltreatment and neglect” for *SRE participating Athlete circumstances
2015 ICD-10-CM Diagnosis Code Y07.53 is also for “Teacher or instructor, who is a perpetrator of maltreatment, neglect” for school student circumstances, or non-school teachers, instructors of participating Athletes in *SRE circumstances.

The important difference is that in 2014 ICD-9 Coach was not specified. Converting ICD-10-CM Y07.53 to ICD-9-CM: “ICD-10-CM Y07.53 converts approximately to: ICD-9-CM E967.8 at ICD9Data.com Perpetrator of child and adult abuse, by non-related caregiver.” Coach is not specified in ICD-9 E967.8. This is a significant change in discernment. [ICD10Data.com]

Today, Doctors remain very influential facilitators for football and all sports’ destinies, because they perform the mandatory pre-participation physical examinations, care for serious Athlete injuries, give permission to return to games after injuries and sit on governing SRE boards but, unlike 1906, doctors are potentially liable.

• Note that Adult as well as Children victims are included in the new codes.
• The 2015 ICD-10 Diagnosis Codes, effective October 1, 2015, not the 2014 and not previous revised codes, defines, that the Coach (also teacher and instructor) of SRE activities, who caused or allowed to be caused, created or allowed to be created the incident(s), injury and/or death (morbidity and mortality) to a Child or Adult Athlete can be identified and named as the perpetrator for the following incidents utilizing the modifier code Y07.53 applied to the diagnostic codes for:
• Child and Adult Athlete Physical and Psychological Endangerment
• Child and Adult Maltreatment and Abuse
• Child and Adult Sexual Abuse
• The specific perpetrator category, which applies to the Coach (also teacher and instructor) now has a reportable, billable, data mine-able ICD-10 Diagnostic Modifier Code, Y07.53,
• The supervisors of Sports, Recreation and Exercise (SRE) activities can be identified as either Coach, teacher or instructor and must be included for athletic activities i.e football Coach, martial arts teacher, cheerleading instructor. There is no room for quibbling.
• After the ICD-10 Diagnostic Code, the Modifier Codes Y07.53 for Coach Offender and circumstances should be listed
• The new definitions include the definition for “Coach Temporary Substitute Caregiver”, the offender, and the circumstances affecting the Athlete victim(s).
• Doctors and health care personnel are mandated to report Coaches, when they are offenders, following Athlete morbidity and mortality diagnoses and treatment, or risk criminal charges for failure to report and civil malpractice law suits should the same Coach commit further harmful incidents, following the Doctor or health care personnels’ unlawful failure to report.
• These new ICD-10 codes will promote safety for potential Athlete Victims and “crystal clear” legal responsibility and duty for potential Coach Perpetrators, following education and training, now atrociously lacking.
• Coaches, the athletic community and everyone have been abandoned and rendered involuntarily ignorant from lack of education and supervision by the Coaches’ supervisors, who themselves are sometimes immune from charge.

For example, when a Child has been Sexually Abused during SRE or Physically Endangered, Maltreated, injured or died during SRE participation, then when preparing a written report to the Child Protective Services (CPS), Department for Community Based Services (DCBS) or County Attorney, medical charting and/or insurance billing, retrievable for investigators and data mining, the following codes should be listed:

Diagnosis: Child Sexual Abuse ICD-10 Diagnostic Code = T74.22XA
Modifier Coach Perpetrator Code is added = Y07.53
or
Diagnosis: Child physical abuse, confirmed, initial encounter = T74.12XA
Modifier Coach Perpetrator Code is added = Y07.53

Other Examples:
2015 ICD-10-CM Diagnosis
Code Y08 Assault by other specified means
Code Y08.0 Assault by strike by sport equipment
Code Y08.01 Assault by strike by hockey stick
Code Y08.01XA Assault by strike by hockey stick, initial encounter
Code Y08.01XD Assault by strike by hockey stick, subsequent encounter
Code Y08.01XS Assault by strike by hockey stick, sequela
Code Y08.02 Assault by strike by baseball bat
Code Y08.02XA Assault by strike by baseball bat, initial encounter
Code Y08.02XD Assault by strike by baseball bat, subsequent encounter
Code Y08.02XS Assault by strike by baseball bat, sequela
Code Y08.09 Assault by strike by other specified type of sport equipment
Code Y08.09XA Assault by strike by other specified type of sport equipment, initial encounter
Code Y08.09XD Assault by strike by other specified type of sport equipment, subsequent encounter
Code Y08.09XS Assault by strike by other specified type of sport equipment, sequela
Code Y08.8 Assault by other specified means

2015 ICD-10-CM Diagnosis
Code T67.3 Heat exhaustion, anhydrotic, water deprivation
Code T67.3XXA Heat exhaustion, anhydrotic, water deprivation initial encounter
Code T67.3XXD Heat exhaustion, anhydrotic, water deprivation subsequent encounter

If the Doctor or other Health Care Personnel determined that a Child or Adult Athlete suffered heat stroke secondary to water deprivation by the Coach, the Doctor would code his chart, report to authorities and insurance billing with Code T67.3SSA + Modifier Code Y07.53. There are many additional new 2015 ICD-10 codes for Child and Adult Athlete injuries that can be modified for the Coach Perpetrator.

The legal Coach-Amateur-Athlete relationship is now “crystal clear” within the definitions. Responsible Coach overseers and responsible Doctor and HCP organizations should hasten to educate and enlighten Coaches, the athletic community, Doctors, HCP and everyone about the duty of Coaches to their Athletes and the legal Coach-Amateur-Athlete relationship.

This reporter has been attempting to inform and educate everyone for several years for the sake of Athletes, who have been harmed, and Coaches, who have been legally blindsided and tried in court and everyone concerned, about the inevitable revision of the, heretofore, obscure Coach definition among definitions and negligent Doctors, who have been charged.

The new ICD-10 Diagnostic Codes, that are scheduled to go into effect October 1, 2015, utilized by international Doctors and health care personnel for medical diagnoses, procedures, medical charting and billing purposes, are much broader categories, allowing for more specific definitions, than the ICD-9 codes, which previously, merely emphasized and included domestic abuse offenses and victimizations and left much for doctors and health care personnels’ interpretations, when providing patient care. Perpetrator codes are now “crystal clear” and specific.

[2015 ICD-10-CM Diagnosis Codes]
[DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services]
[May 2015 YOUTH ATHLETES Sports Programs’ Guidance, Practices, and Policies to Help Prevent and Respond to Sexual Abuse, Report to the Honorable Jackie Speier, House of Representatives]
[Department of Health and Human Services, Office of the Secretary: Administrative Simplification: Change to the Compliance Date for the International Classification of Diseases, 10th Revision (ICD-10-CM and ICD-10-PCS) Medical Data Code Sets Date to Oct. 1, 2015 following GAO Review GAO-14-839R: Aug 19, 2014]
[January 2015 INTERNATIONAL CLASSIFICATION OF DISEASES CMS’s Efforts to Prepare for the New Version of the Disease and Procedure Codes, Highlights of GAO-15-255, a report to the Committee on Finance, U.S. Senate]

This reporter found that “Coach” was hidden in the category “other” in the ‘Surgeon General’s Workshop: “Making Prevention of Child Maltreatment a National Priority: Implementing Innovations of a Public Health Approach’ Lister Hill Auditorium, Rockville (MD), March 30 and 31 2005, Office of the Surgeon General (US), National Institutes of Health, Bethesda, Maryland.” Coach has remained hidden in “other” since that time, a disservice to Athletes and Coaches. When the Surgeon General’s publication was word-searched recently the following was the result: “The following term not found in the book: Coach” because “Coach” was buried several windows beneath the primary dissertation. In depth research was required by this reporter for exposure.

Now the category for “Coach” (also teacher and instructor) of SRE activities is clearly listed among “temporary substitute caregivers” in ICD-10 codes (as YO7.53) and further defined as having a “temporary caregiving role with care and control of the child, and responsibility for the child’s health and welfare”.

This reporter concluded that his publications and posts on this and other websites and blogs, which began many years ago, requesting this category, “Coach, a temporary substitute caretaker” in his recommended amendment of definitions in Child Protections Laws, which was shared-to on request-by investigators from the U.S. Government Accountability Office after multiple emails and phone calls, had uncovered Coach from the category “other” and helped facilitate this definition admission, with his dedicated, persistent work. This website was a valuable resource for the GAO investigation.

This reporter frequently cited the “Coach” hidden omission in the U.S. Surgeon General’s 2005 Workshop in every conceivable communication with interested parties and reported the omission to the U.S. GAO and many U.S. Senators and Congress People. This reporter’s advocacy began in 2007 with intensive full time research and reporting. Avocation, at times, is extremely frustrating, but vitally important.

For Example, a GAO communication to this reporter: > “Thank you again for sharing this information. I have shared it with the team working on this issue……and the efforts around abuse of youth athletes”……
> [Sincerely,…… —- Assistant Director, U.S. Government Accountability Office June 12, 2014 to this reporter.]

For example: the report on this website June 9, 2013 after years of urgent request for both sake of prevention for Athletes, who have suffered morbidity and mortality secondary to coaching endangerment and criminal and civil risk of Coaches, who have frequently been criminally and civilly charged and thus blindsided, stunned and shocked, when charged, because they lacked sufficient education and enlightenment from their supposed overseers:

– Report on this website: “CHILD ATHLETE ABUSE CONSEQUENCES HAVE NOT BEEN PROPERLY PUBLICIZED” from the June 9, 2013
“COACH SUBSTITUTE CARETAKER” DEFINITION:

• The Coach is legally defined as a “Coach Substitute Caretaker” when Coaching Children less than 18 by KY and other states’ DCBS, CPS and U.S. CDC, U.S. NIH, U.S. Surgeon General, U.S. Department of Health and Human Services.
• Legal Scholars and Health Care officials have deciphered, know and understand the definitions for Coaches in the Law. They just haven’t shared them sufficiently with everyone else.
• Both States’ and Federal agencies and governments have made those “Coach-Substitute-Caretaker” declarations, but not publically
• The legal Role of the “Coach Substitute Caretaker” in Sports, Recreation and Exercise has not been properly authored in Section 3, Paragraph 2. of CAPTA 2010 and then issued, published and promulgated for Awareness to general public
• The legal Role of the “Coach Substitute Caretaker” is not “Crystal Clear” because it is not spelled out in the definition language of CAPTA 2010 Law Section 3. Paragraph 2.
– end June 9, 2013 report

The following is from “Highlights of GAO-15-255, a report to the Committee on Finance, U.S. Senate about the INTERNATIONAL CLASSIFICATION OF DISEASES January 2015 CMS’s Efforts to Prepare for the New Version of the Disease and Procedure Codes

“Why GAO Did This Study”
“In the United States, every claim submitted by health care providers to payers—including Medicare and Medicaid—for reimbursement includes ICD codes. On October 1, 2015, all covered entities will be required to transition to the 10th revision of the codes, requiring entities to develop, test, and implement updated information technology systems. Entities must also train staff in using the new codes, and may need to modify internal business processes. Centers for Medicare & Medicaid Services(CMS) has a role in preparing covered entities for the transition. GAO was asked to review the transition to ICD-10 codes. GAO (1) evaluated the status of CMS’s activities to support covered entities in the transition from ICD-9 to ICD-10 coding; and (2) described stakeholders’ most significant concerns and recommendations regarding CMS’s activities to prepare covered entities for the ICD-10 transition, and how CMS has addressed those concerns and recommendations. GAO reviewed CMS documentation, interviewed CMS officials, and analyzed information from a nonprobability sample of 28 stakeholder organizations representing covered entities and their support vendors, which GAO selected because they participated in meetings CMS held in 2013 or met GAO’s other selection criteria. GAO provided a draft of this report to HHS. HHS concurred with GAO’s findings and provided technical comments, which GAO has incorporated, as appropriate.”

It is imperative that Prevent Child Abuse America, and each PCAstate, DCBS, CPS, Schools, National Federation of State High School Associations (nfhs), all state high school athletic associations and all Non-School federations, associations, and leagues and other organizations educate Coaches:
• Coaches are “Temporary Substitute Caretakers”, subject to Child and Adult Abuse, Neglect, Maltreatment Law, because they have custody and control of the Child during Athletic participation, not the parent, guardian, heretofore not defined, and not “crystal clear”
• the new broader diagnostic codes imposed on Doctors and all health care workers,
• who, following athletic injuries, are mandatory reporters to authorities
• because Doctors and all health care workers, including trainers, are subject to criminal charges for failure to report athletic abusive and maltreatment injuries and malpractice if the Coach continues to abuse others because of the doctor’s failure.
• Only the Coaches, who have no immunity to Child Protection Laws, stand to be charged.
• Therefore overseers must prevent the blind siding of Coaches with unlawful and civil charges. Prevention is IMPERATIVE.

“Caregiver: A caregiver is a person, or people, who at the time of the maltreatment is in a permanent (primary caregiver) or temporary (substitute caregiver) custodial role. In a custodial role, the person is responsible for care and control of the child and for the child’s overall health and welfare.

• Primary caregivers must live with the child at least part of the time and can include, but are not limited to, a relative or biological, adoptive, step-, or foster parent(s); a legal guardian(s); or their intimate partner 7.
• Substitute caregivers may or may not reside with the child and can include clergy, coaches, teachers, relatives, babysitters, residential facility staff, or others who are not the child’s primary caregiver(s).

‘Harm: Any acute disruption caused by the threatened or actual acts of commission or omission to a child’s physical or emotional health (ISPCAN 2003). Disruptions can affect the child’s physical, cognitive, or emotional development. Threat of harm occurs when a parent or caregiver expresses an intention or gives signs or warnings through the use of words, gestures, or weapons to communicate the likelihood of inflicting harm to the child. Threat of harm can be explicit or implicit. Explicit threats would include such acts as pointing a gun at the child or raising a hand as if to strike the child.

‘Implicit threats would include such acts as kicking holes in walls or breaking down doors. Disruption of physical health includes, but is not exclusive to, physical injuries, avoidable illnesses, and inadequate nutrition.

“Discussion: We recommend collecting data on all the index child’s primary caregivers and any adults who were responsible for the child at the time of the maltreatment incident. Individuals responsible for the child at the time of the incident can include a single caregiver or multiple caregivers depending on the context, and can include the primary caregiver(s) or a substitute caregiver selected by the child’s primary caregiver. Primary caregivers must live with the child at least part of the time and may include, but are not limited to a relative or biological, adoptive, step-, or foster parent(s); legal guardian(s); or the caregiver’s intimate partner. Caregivers responsible for the index child at the time of the maltreatment may or may not live with the child. A substitute caregiver is defined as having a temporary caregiving role, care and control of the child, and responsibility for the child’s health and welfare. Substitute caregivers can include but are not limited to the following:

• Babysitter
• Residential facility staff
• Teacher
• Clergy
• Coach
• Relatives of the child who are not primary caregivers
• Romantic partner of the primary caregiver (also known as boyfriend/girlfriend, paramour, significant other, intimate partner)

*Expanded data element 98 For the purpose of the document, incident is defined as any contact with CPS, law enforcement, the medical system, or other reporting sources where child maltreatment is alleged or confirmed Information for some data elements in this section may not be available for non-primary caregivers; therefore, developers of the surveillance system will need to decide how missing data should be handled.
[Why GAO Did This Study, Highlights of GAO-15-255, a report to the Committee on Finance, U.S. Senate, January 2015, INTERNATIONAL CLASSIFICATION OF DISEASES, CMS’s Efforts to Prepare for the New Version of them, Disease and Procedure Code http://www.gao.gov/assets/670/668127.pdf]
[Federal Agencies Can Better Support State Efforts to Prevent and Respond to Sexual Abuse by School Personnel
GAO-14-42: Published: Jan 27, 2014. Publicly Released: Jan 30, 2014]

Now compare the 2014 ICD-9 Diagnosis Code to the ICD-10 Diagnosis Code and you will find that the Coach now has a reportable and billable code i.e. Y07.53

2014 ICD-9-CM Diagnosis Code E967.1
Perpetrator of child and adult abuse, by other specified person
• 2014
• Billable Code
• Not A Principal Dx
• Short description: Child abuse by pers NEC.
• ICD-9-CM E967.1 will be replaced by an equivalent ICD-10-CM code (or codes) when the United States transitions from ICD-9-CM to ICD-10-CM on October 1, 2015.
• ICD-9-CM E967.1 is a billable medical code that can be used to specify a diagnosis on a reimbursement claim.
• However, E967.1 describes the circumstance causing an injury, not the nature of the injury, and therefore should not be used as a principal diagnosis.
• You are viewing the 2014 version of ICD-9-CM E967.1.
• More recent version(s) of ICD-9-CM E967.1: 2015.
Convert to ICD-10-CM: E967.1 converts approximately to:
• 2015 ICD-10-CM Y07.499 Other family member, perpetrator of maltreatment and neglect

Convert ICD-9-CM E967.1 to ICD-10-CM
ICD-9-CM E967.1 converts approximately to:
• 2015 ICD-10-CM Y07.499 Other family member, perpetrator of maltreatment and neglect
Note: approximate conversions between ICD-9-CM codes and ICD-10-CM/PCS codes may require clinical interpretation in order to determine the most appropriate conversion code(s) for your specific coding situation.

2015 ICD-10-CM Diagnosis Code Y07.499
Other family member, perpetrator of maltreatment and neglect
2015 Billable Code Not A Principal Dx POA Exempt
• Y07.499 describes the circumstance causing an injury, not the nature of the injury, and therefore should not be used as a principal diagnosis.
• Y07.499 is a billable ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
• On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, Y07.499 – and all other ICD-10-CM codes – should only be used for training or planning purposes until then.
• This is the American ICD-10-CM version of Y07.499. Other international ICD-10 versions may differ.
Present On Admission
• Y07.499 is considered exempt from POA reporting.
Convert ICD-10-CM Y07.499 to ICD-9-CM

V00-Y99

Y07.491
ICD10Data.com Navigator Y07.5
Z00-Z99

2015 ICD-10-CM Diagnosis Code Y07.53
Teacher or instructor, perpetrator of maltreatment and neglect
2015 Billable Code Not A Principal Dx POA Exempt
• Y07.53 describes the circumstance causing an injury, not the nature of the injury, and therefore should not be used as a principal diagnosis.
• Y07.53 is a billable ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
• On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, Y07.53 – and all other ICD-10-CM codes – should only be used for training or planning purposes until then.
• This is the American ICD-10-CM version of Y07.53. Other international ICD-10 versions may differ.
Applicable To
• Coach, perpetrator of maltreatment and neglect
Present On Admission
• Y07.53 is considered exempt from POA reporting.
Convert ICD-10-CM Y07.53 to ICD-9-CM

V00-Y99

Y07.529
ICD10Data.com Navigator Y07.59
Z00-Z99

The 2015 ICD-10 Diagnosis Codes, not the 2014 and previous codes, authorize, that the Coach (also teacher and instructor) of SRE activities can be identified and named as the perpetrator of Child and Adult Athlete Physical and Psychological Endangerment, Maltreatment and Abuse and Sexual Abuse, because the Coach now has a reportable and billable ICD-10 Diagnostic Code i.e. Y07.53, which describes the circumstances and the specific perpetrator, causing an injury to the Child and Adult Athlete, precisely the Coach (also teacher and instructor) of SRE activities. The legal Coach-Amateur Athlete relationship is now “crystal clear”. Responsible Coach overseers should hasten to educate and enlighten Coaches, the athletic community and everyone about the duty of Coaches.

“Drawbacks of the current system, ICD-9-CM, include:
o It does not provide the necessary detail for patients’ medical conditions or the procedures and services performed on hospitalized patients;
o It is 36 years old; ™ It uses outdated and obsolete terminology; ™ It uses outdated codes that produce inaccurate and limited data; and ™ It is inconsistent with current medical practice as it cannot accurately describe the diagnoses and inpatient procedures of care delivered in the 21st century. ICD-10-CM/PCS consists of two parts:
o ICD-10-CM – The diagnosis classification system developed by the Centers for Disease Control and Prevention for use in all United States (U.S.) health care treatment settings. Diagnosis coding under this system uses 3–7 alpha and numeric digits and full code titles, but the format is very much the same as ICD-9-CM; and
o ICD-10-PCS – The procedure classification system developed by the Centers for Medicare & Medicaid Services (CMS) for use in the U.S. for inpatient hospital settings only.

“The compliance date for implementation of ICD-10-CM/PCS is October 1, 2015, for all Health Insurance Portability and Accountability Act (HIPAA)-covered entities. ICD-10-CM, including the “ICD-10-CM Official Guidelines for Coding and Reporting,” will replace ICD-9-CM diagnosis codes in all health care settings for diagnosis reporting with dates of service, or dates of discharge for inpatients, that occur on or after October 1, 2015. ICD-10-PCS, including the “ICD-10-PCS Official Guidelines for Coding and Reporting,” will replace ICD-9-CM procedure codes.

Insert – ICD-10 Codes continued below. – About Collegiate Athletes – Definition of Fiduciary Relationship

“A fiduciary relationship arises where one party places its trust and confidence in a dominant party.12 The Second District Court of Appeal in Prescott v. Kreher, 123 So. 2d 721 (Fla. 2d DCA 1960), for instance, held that a fiduciary relationship generally exists where a confidence is reposed and, on the other side, there is the resultant superiority and influence. . . . The relation need not be legal but may be moral, social, domestic, or purely personal. Thus, the term, “fiduciary” or “confidential” relation as defined is a very broad one. Such a relation has been said to exist and to suffice as a predicate for relief in all cases wherein confidence has been reposed and betrayed. 13

“Under this general rule, particular relationships, including husband and wife,14 principle and agent,15 trustee and beneficiary,16 attorney and client,17physician and patient,18 guardian and ward,19 and minister and parishioner,20 have been held by courts to be fiduciary relationships under Florida law. Fiduciary relations also can emerge, as a matter of fact, from other types of relationships.21 In instances when a fiduciary relationship exists, Florida law imposes on the more powerful party (the fiduciary) a duty to act for the benefit of the principal in all matters relevant to the relationship.22

For instance, the only deterrence for Coaches and recourse for College and Olympic Adult Amateur Athletes before 2015 ICD-10 was education-about and restitution via a Fiduciary Relationship claim.

“In the context of intercollegiate athletics, the nature of the university and student athlete relationship supports the protection of student athletes’ intercollegiate expectations and potential benefits from a professional sports career.23 Although no Florida court has ruled that a college or university owes a fiduciary duty to its student athletes,24 the lack of judicial recognition should not deter academic institutions from recognizing and protecting against the potential legal obligations arising from this type of relationship. Moreover, the extension of the fiduciary concept to the university and student athlete relationship could be imposed by Florida courts to maintain the law’s relevance with the evolving and complex world of intercollegiate athletics.25

“Application of fiduciary concepts in the intercollegiate sports context is supported by several scholars and commentators. One scholar noted that “the law of fiduciary obligation has developed through analogy to contexts in which the obligation conventionally applies.”26 Under this methodology, scholars and commentators have identified several factors inherent in the university and student athlete relationship that warrant the application of fiduciary concepts to this special relationship.27 One commentator, for example, opined that “[t]he most prominent of these factors is the dominance and control which a university exercises over the lives of student athletes.”28 Interestingly, the Colorado Supreme Court in University of Colorado v. Derdeyn, 863 P.2d 929 (Colo. 1993), noted the tremendous influence that a university exerts over its student athletes: “[Student athletes] submit to extensive regulation of their on- and off-campus behavior, including maintenance of required levels of academic performance, monitoring of course selection, training rules, mandatory practice sessions, diet restrictions, attendance at study halls, curfews, and prohibitions on alcohol and drug use.”29

“The Derdeyn court, relying on the testimony of a director of athletics, also looked at the level of dominance college coaches have over student athletes: “[S]ome coaches within their discretion impose curfews; that athletes are required to show up for practice; that athletes are ‘advised. . . on what they should take for classes’; that ‘we have a required study hall in the morning and in the evening’; and that it is ‘fair to say that the athletes are fairly well regulated.’”30

“Accordingly, college coaches develop a special influential relationship with student athletes based on trust and dependence because of the multiple roles coaches play in student athletes’ lives.31 Consequently, an academic institution, through its coaches, has a dominant role into and control over the lives of student athletes that creates a special, or fiduciary, relationship.32 The fiduciary nature of the relationship, therefore, gives the university the responsibility to carry out the reasonable expectations of student athletes.33

University’s Fiduciary Duties

“If Florida courts begin to apply fiduciary concepts in the intercollegiate athletics context, colleges and universities need to become more aware of their fiduciary duties if athletics staff members improperly refer student athletes to sports agents for compensation. Simply, the existence of a university and student athlete fiduciary relationship involves the imposition of the highest standard of duty implied by law.34

“The scope of this special duty can be defined through analogy from cases where courts have acknowledged the special duty universities owe to their students in other circumstances. The U. S. Court of Appeals for the Third Circuit in Kleinknecht v. Gettysburg College, 989 F.2d 1360 (3d Cir. 1993), held that a special relationship existed between a college and a student athlete that was sufficient to impose a duty of reasonable care on a college.35

“Florida has imposed a duty on universities to protect their students in limited situations. The Fourth District Court of Appeal in Gross v. Family Services Agency, Inc., 716 So. 2d 337 (Fla. 4th DCA 1998), held that a university had a duty to students to use ordinary care in providing educational services and programs.36 In particular, the Gross court concluded that “[w]hile a person or other entity generally has no duty to take precautions to protect another against criminal acts of third parties, exceptions to this general rule have emerged, including the ‘special relationships’ exception.”37

“Universities also are liable under other theories of negligence, including negligent hiring, retention, and supervision of employees (i.e., athletics staff).38Therefore, the existence of a special relationship between a university and its students imposes a corresponding duty of care.39

“Florida courts also have imposed a duty on public schools to supervise students placed within its care.40 In these cases, the courts have held that “a negligent failure to act in carrying out this duty of the school is actionable.”41 In carrying out the supervisory duty, a school, and its officials and teachers, “must use the degree of care ‘that a person of ordinary prudence, charged with the duties involved, would exercise under the same circumstances.’”42 A breach of this duty, furthermore, exposes a school to liability for “reasonably foreseeable injuries caused by the failure to use ordinary care.”43 The supervisory duty in Florida is based on the notion that the school is partially standing in place of the student’s parents.44

“Similarly, the university has two primary duties to student athletes under a fiduciary relationship. First, the university has an implied duty to limit institutional conduct that unreasonably interferes with the student athletes’ ability to develop and participate athletically.45 For example, arbitrary and capricious conduct that interferes with an opportunity for student athletes to participate in intercollegiate athletics would be precluded under this duty.46 Second, institutional conduct which promotes its interests ahead of that of the student athlete, is prohibited under this duty.47 The referral of student athletes to sports agents by athletics staff for compensation specifically would be prohibited under this duty because of the coach’s conflict of interest.

University Liability for Recommending Sports Agents

“Colleges and universities may be liable in a breach of fiduciary duty lawsuit if a sports agent, with whom an athletics staff member refers student athletes, damages a student athlete’s professional sports career aspirations and earnings. Florida appellate courts have yet to rule on the validity of student athletes’ property interests in intercollegiate eligibility or prospective professional sports earnings.48 Courts from other jurisdictions, however, are increasingly finding that student athletes have a protected property interest in their intercollegiate eligibility and prospective professional sports earnings.49The federal district court in Hall v. University of Minnesota, 530 F. Supp. 104 (D. Minn. 1982), for example, held that a student athlete’s opportunity to be drafted in the second round of the National Basketball Association draft was a private interest and, as such, protected by the United States Constitution.50In particular, the Hall court concluded that a student athlete “would suffer a substantial loss if his career objectives were impaired.”51 The Hall decision stands in contrast to decisions of courts in other jurisdictions, which held that student athletes do not have a protected property interest in either participating in intercollegiate athletics or future professional sports earnings.52 These holdings were based on the belief that future professional sports earnings, for instance, were “too speculative” to constitute a property interest.53 However, a student athlete’s future professional sports earnings can be ascertained more accurately today due to the sports industry’s use of sophisticated scouting techniques and projections and professional sports leagues’ imposition of rookie salary caps. 54

_________Continued ICD-10 Codes from above before the insert_______________

“The new procedure coding system uses 7 alpha or numeric digits while the ICD-9-CM coding system uses 3 or 4 numeric digits. The new classification system provides significant improvements through greater detailed information and the ability to expand to capture additional advancements in clinical medicine. ICD-10-CM/PCS improvements include:
o Much greater specificity and clinical information, which results in:
• Improved ability to measure health care services;
• Increased sensitivity when refining grouping and reimbursement methodologies;
• Enhanced ability to conduct public health surveillance; and Page 3
• Decreased need to include supporting documentation with claims;
o Updated medical terminology and classification of diseases;
o Codes that allow comparison of mortality and morbidity data; and
o Better data for:
• Measuring care furnished to patients;
• Designing payment systems;
• Processing claims;
• Making clinical decisions;
• Tracking public health;
• Identifying fraud and abuse;
• Conducting research
Adult and child abuse, neglect and other maltreatment, confirmed T74- >
Use Additional
• code, if applicable, to identify any associated current injury
• external cause code to identify perpetrator, if known (Y07.- )
Type 1 Excludes
• abuse and maltreatment in pregnancy (O9A.3- , O9A.4- , O9A.5- )
• adult and child maltreatment, suspected (T76.- )

T74 Adult and child abuse, neglect and other maltreatment, confirmed
T74.0 Neglect or abandonment, confirmed
T74.01 Adult neglect or abandonment, confirmed
T74.01XA …… initial encounter
T74.01XD …… subsequent encounter
T74.01XS …… sequela
T74.02 Child neglect or abandonment, confirmed
T74.02XA …… initial encounter
T74.02XD …… subsequent encounter
T74.02XS …… sequela
T74.1 Physical abuse, confirmed
T74.11 Adult physical abuse, confirmed
T74.11XA …… initial encounter
T74.11XD …… subsequent encounter
T74.11XS …… sequela
T74.12 Child physical abuse, confirmed
T74.12XA …… initial encounter
T74.12XD …… subsequent encounter
T74.12XS …… sequela
T74.2 Sexual abuse, confirmed
T74.21 Adult sexual abuse, confirmed
T74.21XA …… initial encounter
T74.21XD …… subsequent encounter
T74.21XS …… sequela
T74.22 Child sexual abuse, confirmed
T74.22XA …… initial encounter
T74.22XD …… subsequent encounter
T74.22XS …… sequela
T74.3 Psychological abuse, confirmed
T74.31 Adult psychological abuse, confirmed
T74.31XA …… initial encounter
T74.31XD …… subsequent encounter
T74.31XS …… sequela
T74.32 Child psychological abuse, confirmed
T74.32XA …… initial encounter
T74.32XD …… subsequent encounter
T74.32XS …… sequela
T74.4 Shaken infant syndrome
T74.4XXA …… initial encounter
T74.4XXD …… subsequent encounter
T74.4XXS …… sequela
T74.9 Unspecified maltreatment, confirmed
T74.91 Unspecified adult maltreatment, confirmed
T74.91XA …… initial encounter
T74.91XD …… subsequent encounter
T74.91XS …… sequela
T74.92 Unspecified child maltreatment, confirmed
T74.92XA …… initial encounter
T74.92XD …… subsequent encounter
T74.92XS …… sequela

2015 ICD-10-CM Diagnosis Code T74.12XA
Child physical abuse, confirmed, initial encounter
2015 Billable Code Pediatric Only Dx (0-17 years)
• T74.12XA is a billable ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
• On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, T74.12XA – and all other ICD-10-CM codes – should only be used for training or planning purposes until then.
• This is the American ICD-10-CM version of T74.12XA. Other international ICD-10 versions may differ.

Description Synonyms
• Child abuse, physical
• Child physical abuse
• Child victim of physical abuse
ICD-10-CM Coding Rules
• T74.12XA is only applicable to pediatric patients aged 0 – 17 years inclusive.

ICD-10-CM T74.12XA is grouped within Diagnostic Related Group(s) (MS-DRG v30.0):
• 922 Other injury, poisoning & toxic effect diag with mcc
• 923 Other injury, poisoning & toxic effect diag without mcc

Convert ICD-10-CM T74.12XA to ICD-9-CM
ICD-10-CM Code T74.12XA does not contain any entries in the ICD-10-CM Alpha Tabular Index. However, its parent code T74.12 contains the following entries:
• Maltreatment
child
physical abuse
confirmed T74.12

S00-T88
T74.12
ICD10Data.com Navigator T74.12XD

V00-Y99
2015 ICD-10-CM Diagnosis Code T74.11XA

Adult physical abuse, confirmed, initial encounter
2015 Billable Code Adult Only Dx (15-124 years)
• T74.11XA is a billable ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
• On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, T74.11XA – and all other ICD-10-CM codes – should only be used for training or planning purposes until then.
• This is the American ICD-10-CM version of T74.11XA. Other international ICD-10 versions may differ.

Description Synonyms
• Adult abuse, physical
• Adult abuse, physical, non-domestic
• Adult physical abuse
• Adult physical abuse, nondomestic
• Adult victim of non-domestic physical abuse
• Adult victim of physical abuse

ICD-10-CM Coding Rules
• T74.11XA is only applicable to adult patients aged 15 – 124 years inclusive.
ICD-10-CM T74.11XA is grouped within Diagnostic Related Group(s) (MS-DRG v30.0):
• 922 Other injury, poisoning & toxic effect diag with mcc
• 923 Other injury, poisoning & toxic effect diag without mcc

Convert ICD-10-CM T74.11XA to ICD-9-CM
ICD-10-CM Code T74.11XA does not contain any entries in the ICD-10-CM Alpha Tabular Index. However, its parent code T74.11 contains the following entries:
• Maltreatment
adult
physical abuse
confirmed T74.11

S00-T88
T74.11
ICD10Data.com Navigator T74.11XD
V00-Y99

2015 ICD-10-CM Diagnosis Code T74.92
Unspecified child maltreatment, confirmed
2015 Non-Billable Code
• T74.92 is not a billable ICD-10-CM diagnosis code and cannot be used to indicate a medical diagnosis as there are 3 codes below T74.92 that describe this diagnosis in greater detail.
• On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, T74.92 – and all other ICD-10-CM codes – should only be used for training or planning purposes until then.
• This is the American ICD-10-CM version of T74.92. Other international ICD-10 versions may differ.
The following ICD-10-CM Index entries contain back-references to ICD-10-CM T74.92:
• Maltreatment
child
confirmed T74.92

S00-T88
T74.91XS
ICD10Data.com Navigator T74.92XA
V00-Y99

2015 ICD-10-CM Diagnosis Code T74.91XA
Unspecified adult maltreatment, confirmed, initial encounter
2015 Billable Code Adult Only Dx (15-124 years)
• T74.91XA is a billable ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
• On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, T74.91XA – and all other ICD-10-CM codes – should only be used for training or planning purposes until then.
• This is the American ICD-10-CM version of T74.91XA. Other international ICD-10 versions may differ.
Description Synonyms
• Adult abuse
• Adult maltreatment syndrome
ICD-10-CM Coding Rules
• T74.91XA is only applicable to adult patients aged 15 – 124 years inclusive.
Convert ICD-10-CM T74.91XA to ICD-9-CM
ICD-10-CM Code T74.91XA does not contain any entries in the ICD-10-CM Alpha Tabular Index. However, its parent code T74.91 contains the following entries:
• Maltreatment
adult
confirmed T74.91

S00-T88
T74.91
ICD10Data.com Navigator T74.91XD
V00-Y99

Maltreatment
adult
abandonment
confirmed T74.01
suspected T76.01
confirmed T74.91
history of Z91.419
neglect
confirmed T74.01
suspected T76.01
physical abuse
confirmed T74.11
suspected T76.11
psychological abuse
confirmed T74.31
suspected T76.31
history of Z91.411
sexual abuse
confirmed T74.21
suspected T76.21
suspected T76.91
child
abandonment
confirmed T74.02
suspected T76.02
confirmed T74.92
history of – see History, personal (of), abuse
neglect
confirmed T74.02
history of – see History, personal (of), abuse
suspected T76.02
physical abuse
confirmed T74.12
history of – see History, personal (of), abuse
suspected T76.12
psychological abuse
confirmed T74.32
history of – see History, personal (of), abuse
suspected T76.32
sexual abuse
confirmed T74.22
history of – see History, personal (of), abuse
suspected T76.22
suspected T76.92

personal history of Z91.89

015 ICD-10-CM Diagnosis Code T74.22
Child sexual abuse, confirmed
2015 Non-Billable Code
• T74.22 is not a billable ICD-10-CM diagnosis code and cannot be used to indicate a medical diagnosis as there are 3 codes below T74.22 that describe this diagnosis in greater detail.
• On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, T74.22 – and all other ICD-10-CM codes – should only be used for training or planning purposes until then.
• This is the American ICD-10-CM version of T74.22. Other international ICD-10 versions may differ.
The following ICD-10-CM Index entries contain back-references to ICD-10-CM T74.22:
• Maltreatment
child
sexual abuse
confirmed T74.22
• Rape
child
confirmed T74.22

S00-T88
T74.21XS
ICD10Data.com Navigator T74.22XA
V00-Y99

2015 ICD-10-CM Diagnosis Code T74.21
Adult sexual abuse, confirmed
2015 Non-Billable Code
• T74.21 is not a billable ICD-10-CM diagnosis code and cannot be used to indicate a medical diagnosis as there are 3 codes below T74.21 that describe this diagnosis in greater detail.
• On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, T74.21 – and all other ICD-10-CM codes – should only be used for training or planning purposes until then.
• This is the American ICD-10-CM version of T74.21. Other international ICD-10 versions may differ.
The following ICD-10-CM Index entries contain back-references to ICD-10-CM T74.21:
• Maltreatment
adult
sexual abuse
confirmed T74.21
• Rape
adult
confirmed T74.21

S00-T88
T74.2
ICD10Data.com Navigator T74.21XA
V00-Y99

2015 ICD-10-CM Diagnosis Code T74.32
Child psychological abuse, confirmed
2015 Non-Billable Code
• T74.32 is not a billable ICD-10-CM diagnosis code and cannot be used to indicate a medical diagnosis as there are 3 codes below T74.32 that describe this diagnosis in greater detail.
• On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, T74.32 – and all other ICD-10-CM codes – should only be used for training or planning purposes until then.
• This is the American ICD-10-CM version of T74.32. Other international ICD-10 versions may differ.
The following ICD-10-CM Index entries contain back-references to ICD-10-CM T74.32:
• Maltreatment
child
psychological abuse
confirmed T74.32

S00-T88

T74.31XS
ICD10Data.com Navigator T74.32XA
V00-Y99

2015 ICD-10-CM Diagnosis Code T74.31
Adult psychological abuse, confirmed
2015 Non-Billable Code
• T74.31 is not a billable ICD-10-CM diagnosis code and cannot be used to indicate a medical diagnosis as there are 3 codes below T74.31 that describe this diagnosis in greater detail.
• On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, T74.31 – and all other ICD-10-CM codes – should only be used for training or planning purposes until then.
• This is the American ICD-10-CM version of T74.31. Other international ICD-10 versions may differ.
The following ICD-10-CM Index entries contain back-references to ICD-10-CM T74.31:
• Maltreatment
adult
psychological abuse
confirmed T74.31

S00-T88

T74.3
ICD10Data.com Navigator T74.31XA
V00-Y99

2015 ICD-10-CM Diagnosis Code T74.22
Child sexual abuse, confirmed
2015 Non-Billable Code
• T74.22 is not a billable ICD-10-CM diagnosis code and cannot be used to indicate a medical diagnosis as there are 3 codes below T74.22 that describe this diagnosis in greater detail.
• On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, T74.22 – and all other ICD-10-CM codes – should only be used for training or planning purposes until then.
• This is the American ICD-10-CM version of T74.22. Other international ICD-10 versions may differ.
The following ICD-10-CM Index entries contain back-references to ICD-10-CM T74.22:
• Maltreatment
child
sexual abuse
confirmed T74.22
• Rape
child
confirmed T74.22

S00-T88

T74.21XS
ICD10Data.com Navigator T74.22XA
V00-Y99

15 ICD-10-CM Diagnosis Code T74.21
Adult sexual abuse, confirmed
2015 Non-Billable Code
• T74.21 is not a billable ICD-10-CM diagnosis code and cannot be used to indicate a medical diagnosis as there are 3 codes below T74.21 that describe this diagnosis in greater detail.
• On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, T74.21 – and all other ICD-10-CM codes – should only be used for training or planning purposes until then.
• This is the American ICD-10-CM version of T74.21. Other international ICD-10 versions may differ.
The following ICD-10-CM Index entries contain back-references to ICD-10-CM T74.21:
• Maltreatment
adult
sexual abuse
confirmed T74.21
• Rape
adult
confirmed T74.21

S00-T88

T74.2
ICD10Data.com Navigator T74.21XA
V00-Y99

Unspecified child maltreatment, confirmed
2015 Non-Billable Code
• T74.92 is not a billable ICD-10-CM diagnosis code and cannot be used to indicate a medical diagnosis as there are 3 codes below T74.92 that describe this diagnosis in greater detail.
• On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, T74.92 – and all other ICD-10-CM codes – should only be used for training or planning purposes until then.
• This is the American ICD-10-CM version of T74.92. Other international ICD-10 versions may differ.
The following ICD-10-CM Index entries contain back-references to ICD-10-CM T74.92:
• Maltreatment
child
confirmed T74.92

S00-T88

T74.91XS
ICD10Data.com Navigator T74.92XA
V00-Y99

015 ICD-10-CM Diagnosis Code T74.91
Unspecified adult maltreatment, confirmed
2015 Non-Billable Code
• T74.91 is not a billable ICD-10-CM diagnosis code and cannot be used to indicate a medical diagnosis as there are 3 codes below T74.91 that describe this diagnosis in greater detail.
• On October 1, 2015 ICD-10-CM will replace ICD-9-CM in the United States, therefore, T74.91 – and all other ICD-10-CM codes – should only be used for training or planning purposes until then.
• This is the American ICD-10-CM version of T74.91. Other international ICD-10 versions may differ.
The following ICD-10-CM Index entries contain back-references to ICD-10-CM T74.91:
• Maltreatment
adult
confirmed T74.91

S00-T88

T74.9
ICD10Data.com Navigator T74.91XA
V00-Y99

[ICD-10-CM/PCS THE NEXT GENERATION OF CODING, June 15, 2015 DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services]

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