Health Information Management

So long, 2014!

HIM-HIPAA Insider, January 12, 2015

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We’ve come to the end of another year filled with ICD-10 in the spotlight, for good and bad reasons.

First the bad—we’re still waiting to implement ICD-10. We thought we were all set for October 1, 2014. CMS was standing firm. Healthcare organizations were preparing. And then Congress intervened.
At the end of March, the House and Senate passed the Sustainable Growth Rate (SGR) patch bill that included at least a one-year delay in ICD-10 implementation. President Obama signed the bill into law April 1. Sadly, it wasn’t a joke.
So we’re left with more training costs, more time to worry, and no guarantee 2015 will be the year.
That doubt comes in part because the AMA has continued to beat its “kill ICD-10” drum. According to the AMA, ICD-10 is evil (literally—they claim ICD-10 would serve Darth Vader). The AMA also complained about the cost of implementing ICD-10 again (without noting how much each delay has added to those costs).
AHIMA and 3M offered a rebuttal in the Journal of AHIMA. A group of 3M analysts published a study claiming the costs of ICD-10 implementation are nowhere near what Nachimson Advisors (who were paid by AMA, incidentally) claimed. Nachimson decried the 3M study as flawed, leaving everyone to believe whatever suited their purposes.
The mainstream media (and the AMA) continue to focus on the wrong things in the ICD-10 discussion—namely external cause codes. In the past, they harped on the bitten by duck codes. 2014 was the year of sucked into a jet engine, subsequent encounter. None of them seem to understand the concept of subsequent encounter. It’s not the second time you were sucked into a jet engine (or broke your left index finger). It’s follow-up treatment.
Maybe if physicians took the time to understand ICD-10 they might not be so staunchly opposed. Then again, the AMA represents less than one-third of physicians, so I’m not sure what most physicians think. We just know what the AMA wants us to think they think.
Now for the good news. Yes, we do have good news. One, the ICD-10 date is still standing at October 1, 2015, despite an AMA push over the last couple months for another two-year delay. Congress decided not to include another delay in the massive spending bill it passed in December.
We’re unlikely to see any standalone bill kill ICD-10, even though Republicans in Congress are expected to reintroduce their Cutting Costly Codes bills which previously died in committee. However, we’re not out of the woods yet. Congress could still decide to add a delay into the SGR patch (or permanent fix) next year.
But the pro-ICD-10 crowd seems to have found our voice. AHIMA has been at the forefront of social media and grassroots campaigns to support ICD-10. I don’t know if they are making a difference, but at least we’re getting our side of the story out. AMA’s narrative that ICD-10 won’t improve patient care and will bankrupt physicians has stronger competition than ever.
Even with the latest delay, many organizations continued to train on ICD-10 and dual code, just at a slower pace. That’s better than the near complete stop we had when the previous delay was announced in 2012.
We have a lot of work to do in 2015 (and beyond—implementation problems won’t end when we flip the switch). But we should look forward with optimism and do our best to spread the word about the value of ICD-10.
This article originally appeared on HCPro’s ICD-10 Trainer blog.


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