Many but not all physicians oppose the federal push to implement ICD-10. One doc who wants an ICD-10 deflection rather than a full stop is, oddly enough, a Texan.
“We've got to find some middle ground on this,” pleaded Dr. Joseph Schneider, chief medical information officer and medical director of clinical information at Baylor Health Care System, Dallas.
But Schneider's moderate stance on ICD-10 puts him at odds with his own state medical society, which recently turned up the gas on an already simmering ICD-10 cauldron.
The association—of which Schneider is a member—posted a call to action on its website, urging its 48,000 members to join with physicians nationwide in writing Congress, asking it to delay ICD-10 implementation for two years.
Meanwhile, the Association of Medical Directors of Information Systems, a professional association of physician informaticists, recently posted Schneider's compromise proposal on the AMDIS listserv, where it garnered both support and criticism.
The plan calls for going forward with the current Oct. 1, 2015 compliance date, but making ICD-10 use optional for hospitals and physicians for the next three years. Health plans and other claims handlers, however, would be required to process claims in either the currently used ICD-9 code sets, if that's how they're received, or in ICD-10. A multidisciplinary panel—he likened it to the 1990s' military base-closing commission—would lead a national discussion on clinical coding and come up with a transition plan.
The TMA's ICD-10 opposition, though, has the backing of the American Medical Association, and its call for congressional intervention is no idle threat.
Earlier this year, operating in stealth mode, an as-yet unidentified member of Congress slipped a single sentence into the massive annual Medicare physician payment bill, backing off a determined HHS and CMS by mandating that the administration extend its ICD-10 compliance date by at least one year, which it did, to Oct. 1. 2015.
But the next congressional knife stuck into HHS' ICD-10 plans won't be slipped in so quietly. The next could be a guillotine, dropped on ICD-10 amid partisan cheers with a loud public thunk. “Come January, we'll have a Republican-controlled House and Senate and what better issue than ICD-10 to stick it to the CMS,” Schneider said. “It seems like a ripe fruit for them to grab at and they will.”
If ICD-10 becomes a political weapon, Schneider said, providers and policymakers will be deprived of the nuanced discussion of coding strategy that they need.
The push to move forward with the transition does have supporters in the industry. The Chicago-based American Health Information Management Association, which represents medical records professionals, has already launched a pro-ICD-10 campaign on Capitol Hill, said its CEO, Lynne Thomas Gordon.
“Our membership has been very active and engaged in contacting their legislators,” Thomas Gordon said, including a Twitter campaign at #icd10Matters, in which AHIMA members have sent 14,000 tweets to their representatives.
“We'd like to think we're winning,” Thomas Gordon said, of the lobbying effort, but, “We know it only takes one legislator to add an amendment.”
AMDIS hasn't taken an official stance on the ICD-10 issue, according to its long-time chairman and veteran informaticist Dr. William Bria, who personally supports Schneider's view that the situation needs less, not more, political intervention.
It would make sense, Bria said, for organizations that are ready for the transition to move forward and work out the bugs and learn from their experiences as early adopters, even though ICD-10, he said, “is so far away from everything we need in a coding system. “It would be different if you had something in your pocket that would improve the situation, but we don't.”
Follow Joseph Conn on Twitter: @MHJConn
