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  ICD10 Watch
by Carl Natale

Texas lawmaker introduces bill to ban ICD-10 implementation

Rep. Ted Poe, R-Texas, has introduced a bill that would "prohibit the Secretary of Health and Human Services replacing ICD-9 with ICD-10 in implementing the HIPAA code set standards."

H.R. 1701 was introduced in the U.S. House of Representatives on Wednesday, but there is no text available yet. So I have no idea how this would work. Although the title pretty much says it all.

[See also: Turkey assaults ICD-10 codes in Congress]

I have no idea how far this will go. It has only been introduced to the House Energy and Commerce, and Ways and Means committees. Those committees need to schedule hearings and vote on the bill. Then the full House of Representatives will have to vote as will the U.S. Senate. Then of course President Barack Obama will have to sign it.

I have a hard time believing all that will line up against ICD-10 implementation. But anything can happen. And who knows what kind of backroom deal could be made. Would it be possible that ICD-10 would be sacrificed to save the Affordable Care Act? Again, I have doubts.

While Poe makes the required Republican argument against onerous bureaucratic mandates, there's another favored Republican crusade that can save ICD-10 implementation. No politician wants to be seen as soft on fraud and abuse. So if the proper people explain how ICD-10 coding can be a valuable tool for detecting fraud and abuse, it's a lock.

Again, anything can happen.

Politics as unusual

Earlier this month, the Senate Finance Committee approved the nomination of Marilyn Tavenner to lead the Centers for Medicare and Medicaid Services. The Senate has refused to approve this position since 2006.

I don't think this signals a renaissance of reason. But it's not a bad sign that CMS will have leadership who isn't blocked by angry Republicans. Maybe she has the chops to win over Poe.


You would not be quite so

You would not be quite so cock sure of yourselves if it was your physician practice's cashflow that was at risk if the conversion turns out to be disaster... which it will. ICD is a core variable that is connected to authorization and referral processes, risk adjustments, and payer denial logic to name just a few. Any and all of these processes will be thrown into a state of uncertainty, even assuming that all the codes flow through the thousands of systems without a hitch. At the very least, payments will slow dramatically as payers come to grips with millions of transactions from providers who are trying to understand an alien code nomenclature. See 5010... as denials or simple non-payment occurs, clearinghouse and payer cust service staff are quickly overwhelmed and everyone starts pointing fingers. This should be rolled out over a period of years. CMS and all of the ICD-10 cheerleaders are basically taking the fiscal health of thousands of providers, small businesses, and betting it all on red

Marylins would come up to be

Marylins would come up to be a sharp leader lady and the good thing is that majority of people are likely to agree with her.

Last Friday night, John

Last Friday night, John Stossel gave this guy Poe a platform to spew his ignorance. Listen to some of the things this guy states:

It is hard to believe that

It is hard to believe that there are those that are still proposing that we continue with a standard for defining the patient health condition that is 30 years old despite the fact that the rest of the world has moved on to ICD-10. The reasoning for not moving forward is flawed and easily debunked, but we still have seemingly passionate persons with little understanding of what they are talking about, fighting against the next level of standard for defining patient conditions. I wrote a white paper on the case for moving forward which I believe addresses some of the issues that keep coming up, but I'm not sure that those fighting implementation have any interest in looking at the real problem. Our current national data on health care is totally unreliable and does not capture major parameters of the patient condition that define not just what we do for patients, but why.
Joe Nichols MD

Health Data Consulting

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