by Justin Werfel and Marta Herschkopf
Problem: April Fool’s Day

Each paragraph gives a hypothetical doctor’s notes describing a historical person or fictional character, and a particular complaint that can be coded for using the ICD-10 clinical documentation system. The enumeration before the notes gives the patient’s name; the line after the notes gives the ICD-10 code (letters provided, digits missing).

The patients and codes are:

  • Michel Lotito: Z72.4 (Inappropriate diet and eating habits)
  • Abu Hasan: R14.3 (Flatulence)
  • Melisha Tweedy: W61.39XS (Other contact with chicken, sequela)
  • Aeschylus: W59.22XA (Struck by turtle, initial encounter)
  • Joseph Buquet: Y92.253 (Opera house as the place of occurrence of the external cause)
  • Veruca Salt: W53.29XA (Other contact with squirrel, initial encounter)
  • Therese Defarge: Y93.D1 (Activity, knitting and crocheting)
  • James Hook: Z89.111 (Acquired absence of right hand)
  • Poe Dameron: V95.41XA (Spacecraft crash injuring occupant, initial encounter)
  • Buddy Pine: V97.33XA (Sucked into jet engine, initial encounter)

The number of digits in each code matches the number of lines in the notes. Indexing into each line by the digits in order, and concatenating for all patients, gives the phrase TAKE LETTER IN NAME BEFORE LAST LETTER IN NOTES.

Taking the letter of each patient’s name that comes before the last letter in the corresponding notes (e.g., the final letter at the end of the first paragraph of notes is E; the letter in “Michel Lotito” immediately before the E is H) gives the answer HATCHET JOB.