Looking back on it, Shark Week 2022 came and went relatively quietly on the streets of Turquoise Health, largely because we were dealing with a payer datanado instead of the more beloved sharknado.

It’s a new year and a new opportunity to celebrate though, and this time, we’re going all in. What better way to celebrate the most important week of the year than looking at some shark-related episodes of care? And no, we did not google “shark week diagnosis codes” in preparation. We definitely did not.

If we had done that, we would have stumbled upon the idea that this is a largely popular topic to discuss. In the wide world of shark-related injuries, we’d be remiss if we didn’t start off with the greatest shark movie (and soundtrack) of all time, Jaws.

In the movie, there’s a brief bit of downtime for the fearless trio hunting down a boat-and-people-eating shark, so they did the Episode of Care authors a real solid by hosting a scar-off of sorts. The scene gave us a real treat of a list of injuries to catalog, such as:

Moray eel bite
Arm wrestling contest - semi-final (how…why…what??)
Bull shark scrape
Thresher shark tail
Broken heart
Tattoo removal

That moray eel bite scar looked like a doozy, so we’ll assume Hooper had to get that one looked at by a professional. This would give him a good baseline to understand what a minor shark bite injury and treatment plan would look like. Useful intel for a future shark bite that required a bit more treatment, but we digress.

Hoops would have been triaged with a diagnosis code:

W56.51 - bitten by other fish

Or perhaps, if the wound got infected, T61.91XA - Toxic effect of unspecified seafood, accidental (unintentional), initial encounter*

Based on the scar size, he probably needed a complex repair of a wound to the arm between 2.6 and 7.5 cm in size. That means CPT 13121 is checking into the game.

Next, where would he have gone to get this treatment? Tough to say, really, given he was probably on the high seas at the time. Deck-Of-A-Boat Community Medical Center doesn’t exist in our data, so we’ll give our guy Hooper options with his backstory here and do a comparison of a handful of Core Based Statistical Areas (CBSAs) located in coastal states.

Being a forward thinker, Hooper knew that urgent care centers would be more cost-effective than going to the ER, so he pulled up Rate Sense from The Orca, where we hear they have great wifi, and checked out negotiated rates at urgent care centers across a few different states.

Complex Arm Wound Repair: Negotiated Unit Price Percentiles































You can catch us staying far away from shark-infested waters this week (and all weeks, really…who are we kidding, we are data nerds and not adventurists), and while we can’t really help the Jaws team estimate the cost of replacing the beloved boat Jaws attempted to eat for dinner, we can at least get the team prepped and ready for getting their minor injuries treated when it’s all said and done***.

Research your own moray eel treatment plan on Rate Sense here.

*creative liberties taken with this one, since the eel may not have been seafood at the time of the attack

**using coastal CBSAs
***Are we skating right on by those Jaws end scenes, which feature slightly more than minor injuries, for the sake of a light-hearted blog? Yes. Yes, we are.