ICD-10 debate doesn't take time off for the holidays

Carl Natale
by Carl Natale

Nothing says the holidays like arguing over ICD-10 implementation. Both sides of the debate seem to be making their cases to Santa Claus to consider the ICD-10 code sets naughty or nice.  

Jennifer Della’Zanna, who teaches medical coding, makes the argument this week that it's time to stop arguing about ICD-10 implementation. She relies on three points:

  1. ICD-10 implementation will not cost as much as small medical practices fear.
  2. Leapfrogging ICD-10 coding to ICD-11 implementation is a false argument.
  3. ICD-10 documentation is not the villain previously thought.

That last point about documentation is worth digging deeper into. She says:

"ICD-10 is not the only change requiring increased documentation, which is what most of my trainees worry about. And it’s not only ICD-10 creating new processes for how we care for our patients, which is another worry for trainees and physicians. All the initiatives and progress in today’s healthcare require the same changes in thinking and upgrades to documentation, but ICD-10 seems to take all the blame."

So if we delay ICD-10 implementation for two more years, physicians are going to have to spend the time documenting greater specificity anyway thanks to:

  • Patient Protection and Affordable Care Act
  •  Clinical Quality Measures
  • Electronic Health Records/Meaningful Use
  • Health Information Exchanges
  • Accountable Care Organizations

And vigorously opposing all those initiatives is tiresome. But that's not stopping anyone. Here are a few more arguments from the week:

Doctors Seek Another ICD-10 Delay

Another round up of AMA vigorous opposition with this spokesman's quote:

"The AMA's number one priority for the lame duck session is fixing the sustainable growth rate [formula] and that has been the focus of our recent grassroots and lobbying efforts... The AMA will continue its work on ICD-10 when the new Congress convenes. The results of end-to-end testing will be pivotal and a GAO report is also expected to be released next year."

(HealthLeaders Media)

A Response to AMA President Dr. Robert Wah

The coalition has a point-by-point response to the speech before the  American Medical Association (AMA) House of Delegates last month that framed the battle against ICD-10 in the Star Wars universe.

  • There are injuries caused by jet engines and flaming water skis that need to be counted.
  • The increase in ICD-10 codes does not mean physicians will have to know 68,000 ICD-10 codes.
  • "More precise data should lead to better identification of potential quality problems and assessment of provider performance."

I also want to note that the AMA's own PR states the "potential complications from a bite could be easier to monitor under the new code set" when talking about how inadequate ICD-9 codes are for a cat bite. (Coalition for ICD-10)

A view from the physician side of the ICD-10 debate

James S. Kennedy is a physician from Tennessee who wants to see some changes that can put an end to physicians vigorously opposing ICD-10 implementation. Mostly it's about interacting with physicians more, building trust and recognizing their challenges. (ICD-10 Trainer)

ICD-10 Delay Again? Don't Do It

Deborah Graham writes against delaying ICD-10 implementation again. She even suggests making compliance voluntary and dual coding acceptable. (InformationWeek)

Five Commonly Overlooked ICD-10 IT Transition Strategies

  1. Inventory all your IT
  2. Review functionality of all your systems
  3. Have users of the technology help find problems
  4. Schedule end-to-end testing
  5. Set clear, attainable goals for all initiatives

(EMR and HIPAA)

CDI Tips Developed to Maximize ICD-10-CM/PCS

Basically, it's a reminder that there's a handy, extensive collection of clinical documentation tips. (Journal of AHIMA)