PolitiFact: Bloggers say Obamacare coding system could usher in beheadings

One blog published an article titled, "ObamaCare Medical Codes Confirm: Execution by Beheading To Be Implemented in America." We took a closer look.
One blog published an article titled, "ObamaCare Medical Codes Confirm: Execution by Beheading To Be Implemented in America." We took a closer look.
Published Jan. 4, 2014

We've heard people give lots of reasons for opposing Obamacare. But until a reader sent us some Internet links recently, we hadn't realized that one of the fears being spawned by Obamacare was that it could usher in legal beheadings across America.

The reader pointed us to a variety of blog posts, such as one headlined, "Obamacare Medical Codes Confirm: Execution by Beheading to Be Implemented in America." As if this wasn't scary enough, this post was accompanied by a photograph of a masked executioner swinging a curved sword downward, just inches from the neck of the condemned.

What's going on here?

The idea appears to trace back to a November post by Lorri Anderson on the blog Freedom Outpost. Anderson's piece was later reposted, excerpted or promoted uncritically on a range of other blogs.

Anderson cites a document known as ICD-9, which refers to the ninth update of the "International Classification of Diseases." ICD-9 is a lengthy list of medical conditions and causes of death published by the World Health Organization and used in the United States by medical professionals for billing purposes and by health statisticians who study causes of death.

One of the categories in ICD-9 is this one: "Legal execution: All executions performed at the behest of the judiciary or ruling authority (whether permanent or temporary) as: asphyxiation by gas, beheading, decapitation (by guillotine), capital punishment, electrocution, hanging, poisoning, shooting, other specified means."

Anderson wrote that the connection between the coding system, Obamacare and legal execution would "make any American's hair stand up on the back of their neck." But if anything, subsequent posts on other websites destroyed any nuances she included. One even accompanied a blog post with a drawing of Uncle Sam with his head in a guillotine.

WHO's coding system

Here's the reality about what the World Health Organization's coding system does and doesn't do.

The United States medical system currently uses ICD-9 and is in the process of switching to ICD-10. Doctors' offices use the codes to fill out Medicare and Medicaid claims, among other things. Their billing and practice management software is based on them. Their employees are trained to use them.

The transition to ICD-10 is somewhat controversial, though not because of beheading. The American Medical Association says that depending on the size of the medical practice, it'll cost $83,290 to more than $2.7 million to switch. Doctors are dealing with so many other expensive regulatory changes, the association has begged since 2011 to delay or give up on the switch altogether.

No beheadings

So one can make a reasoned argument over details of how, or whether, the United States should transition to the new coding system. But the possibility of beheadings is just scare talk. Here are some of the problems:

• A doctor can't bill an insurer for a beheading. Obamacare — a program that addresses health care for the living — doesn't have anything to do with beheading. The "beheading" category in the code is for the purposes of compiling death statistics, something the Centers for Disease Control and Prevention handles. The CDC uses the codes to make apples-to-apples comparisons with other countries.

• The "beheading" coding category long predates Obama. The coding for "beheading" has been standard in the United States since at least 1979, when the CDC adopted ICD-9 for the purposes of compiling death statistics.

• There is no legal beheading in the United States today, and the president couldn't change that even if he wanted to. The military uses only lethal injection, and the federal government essentially does as well. Lethal injections are also used in 35 states, with a dwindling number of states using electrocution, the gas chamber, hanging or a firing squad. No state uses beheading.

The reason beheading is in the code at all is because it is a common method of execution in Saudi Arabia and some other countries, and is practiced by some militant and terrorist groups. So for an international coding system, beheading, for better or for worse, is needed.

Our ruling

Bloggers have recently offered posts headlined like this one: "Obamacare Medical Codes Confirm: Execution by Beheading to Be Implemented in America." But the coding system in question long predates Obama, and the "beheading" classification is only relevant for death statistics, not for insurance billing that would be under Obamacare's purview.

Finally, the beheading code is for statistical purposes, not for setting policy. Bloggers, in a game of telephone, have turned a questionable claim into a ridiculous one. Pants on Fire!