“The King’s Evil” in the ICD-10-CM Index?

by Andrea Houghton, MPH, RHIA, CCS, CCS-P, CDIP

I recently had the privilege of attending an exhibition about the English monarch Charles II at the Queen’s Gallery in London, England. After a long Civil War in England from 1649-1660, when Charles II was restored to the throne in 1660, there were some interesting ideas about illness that he brought back into fashion. It was believed that the king could cure a form of tuberculosis affecting the lymph nodes of the neck, termed scrofula, just by merely touching a person. Ceremonies were held where people suffering from scrofula would kneel and be touched by the monarch’s hand. Proclamations were published by the King advertising when and where these ceremonies would take place. It is estimated that Charles II touched almost 100,000 people during his reign. There were also coins in circulation at the time that an individual could wear that were touched by the king and therefore deemed to hold healing powers. Because of its association of seeking out treatment from the King, scrofula was known to the public as “The King’s Evil”.

For those coder brains now wondering if you can find ‘King’s Evil’ in the ICD-10-CM index, no you cannot. You can, however, find the term scrofula in the index:

Scrofula, scrofulosis (tuberculosis of cervical lymph glands) A18.2
The tabular reads: A18.2 Tuberculous peripheral lymphadenopathy

Thankfully, the 21st century has better treatment modalities for scrofula than seeking out a monarch’s touch which might pose some difficulty in a country without a monarch. Treatment now consists of the conventional treatment for tuberculosis: antibiotic regimens.


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About the Author

Andrea Houghton, MPH, RHIA, CCS, CCS-P, CDIP
Andrea Houghton has over twenty years’ experience participating in various roles in health information management including coding, auditing, and compliance. She currently is the Coding Manager for Lucile Packard Children’s Hospital Stanford. She also works for CHIS, Inc, a consulting firm specializing in providing coding services to the University of California at San Francisco.

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