CHAPTER 1

Medical Coding in History

The Black Death

Medical coding in its earliest form started as an attempt to avoid the Black Death. The bubonic plague, caused by the bacteria Yersinia pestis, arrived in Sicily via ship rats in 1347. It spread rapidly, reaching England in 1348. Almost half the city of London’s population of 70,000 died of the disease over the next 2 years. Given that life expectancy at the time was about 26 years and about 35% of children died before the age of 6, the Black Death contributed to the increased demise of the already death-ridden populace.

Italian author Giovanni Bocaccio lived through the plague in Florence in 1348. In his book The Decameron (1921), he describes how the Black Death got its name:

In men and women ...

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