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The Debate over ICD-10 isn’t that One Sided

February 12, 2015
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This past week, the House of Representatives’ Energy and Commerce Committee’s Subcommittee on Health held a hearing on the transition to ICD-10. In many ways, it encapsulated all the talking points of this debate that we’ve heard over the past few years.
The pro side vs. the con. The “ICD-10 is long overdue, is appropriately more specific, will increase research for diseases, is not as costly as some say, and another delay would be terrible” crowd vs. the “ICD-10 is too costly, too granular, the industry isn’t ready, and it’s not fair to not reimburse physicians because they can’t code” crowd. 
The odd thing about the panel that presented at the hearing is that it was completely one-sided. One doctor, William Jefferson Terry, M.D. from the Mobile (, Ala.) Urology Group, represented an anti-ICD-10 voice. He represented the American Urology Association and spoke out against the transition.
Everyone else, including two doctors, spoke in favor of the transition. In fact, when Rep. Joe Pitts (R-PA) took a vote asking panelists if the health industry was ready to implement ICD-10. Everyone, except Terry, said yes. When he asked if another delay should be opposed, everyone again said yes except Terry.
It kind of reminded me of a famous bit from The Simpsons.
At one point during the hearing, one Congressman told Terry that he probably felt like he was at the Alamo. Terry jokingly responded that he had his kevlar suit on. 
Terry may have been on a bit of an island (there was one doctor in Congress on the committee that took up his cause, quite vocally too) this week on the panel, but make no mistake about it, he represented A LOT of people in his anti ICD-10 crusade. The American Medical Association (AMA) has, somewhat famously, railed against ICD-10. The powerful advocacy group alone represents a lot of doctors. 
That’s why I was disappointed to see the hearing go down this way. The AMA should have been at the hearing, or at least the Medical Group Management Association (MGMA). For what it’s worth, a representative from the AMA told me they were not invited. They did submit comments, which touched upon their concerns with testing, cost, quality measurement, and other factors. 
Some of their points are pertinent and could have been helpful in the discussion. Dr. Terry, bless his heart, did an admirable job summing up the con side. There’s no way anyone could have done it alone. The points on testing, for instance, went mostly ignored. 
Whether you think ICD-10 should move forward on Oct. 1, 2015 or you think a third delay is necessary, or if you think a transition to ICD-11 is a better plan, you have to respect that this debate isn’t as one sided as the hearing made it seem. If it was, the past two delays wouldn’t have happened so easily. 
We’re at a crossroads with ICD-10. 2015 is put up or shut up year. Someone on the panel, I forget who, said either we move forward in 2015 or we pull the plug. I tend to agree. Another delay would be an insane move. It would punish the people who have been ready and are ready. 
Yet, we can’t forget there are plenty of people—like Dr. Terry—who have legitimate gripes with ICD-10. Higher denial rates could kill a small physician office, where cash flow is king. 
We need these people in the discussion to figure out the best plan of action. Someone on Congress, and again my memory is hazy and the hearing ran a few hours long (achingly so), wondered why this had to be an either/or. Why is it that one side is absolutely right and the other is absolutely wrong? 
They both have arguments to be made. Unfortunately, this week, one side didn’t get as much of a chance to state their case.