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Coalition Fights AMA’s Stance on ICD-10

December 5, 2014
by Rajiv Leventhal
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The Coalition for ICD-10, a broad-based healthcare industry advocacy group, fired back at American Medical Association (AMA) President Robert Wah’s recent criticism of the transition to the ICD-10 coding set.

In an address to AMA's House of Delegates in November, Dr. Wah, M.D., characterized the planned implementation of ICD-10 as analogous to the dark forces controlling the galaxy in the movie “Star Wars.” He said in the speech, “Each of the six ‘Star Wars’ films has this line: ‘I have a bad feeling about this.’ That’s a common reaction to ICD-10.  If it was a droid ICD-10 would serve Darth Vader.”

In a Dec. 4 blog post, the Coalition did not take too kindly to Wah’s statement. “Dr. Wah’s attempt at humor is unfortunate because the quality and precision of our national healthcare data is a serious matter. In this country, we use coded data to assess quality of care, make benefit coverage decisions and to determine physician and hospital payment. The financial viability and performance assessments of hospitals and physicians are impacted by the data. Yet we continue to rely on an outdated 1970s-era coding system for reporting diagnoses and inpatient hospital procedures.”

In his speech, Wah further said, “We’d see 13,000 diagnosis codes balloon into 68,000—a five-fold increase. Sucked into a jet engine?  Burned by flaming water skis? Yes, there are codes for that. We all know ICD-10 is expensive to implement. We don't know if it will improve care. For more than a decade, the AMA kept ICD-10 at bay—and we want to freeze it in carbonite!

The Coalition responded to that, saying that “Using cause of injury codes to imply that the coding detail in ICD-10 will be a burden to physicians is at best disingenuous because physicians are not required to report cause of injury codes, except in very limited situations such as injuries caused by medical treatment, like removing the wrong limb. Furthermore, the current ICD-9 system has similar cause of injury codes and their existence has never been a burden.”

The Coalition goes on to compare the transition to ICD-10 to the English language, attesting that just like no one knows all the words in a dictionary, physicians will only use codes relevant to their patient populations. It also adds that much of the additional specificity in ICD-10 was at the request of medical specialty societies.

The Coalition continues, “As to whether ICD-10 will improve care, it would seem obvious that more precise data should lead to better identification of potential quality problems and assessment of provider performance. There are multiple provisions in current law that alter Medicare payments for providers with excess patient complications. Unfortunately, the ICD-9 codes available to identify complications are woefully inadequate.

Recently, a number of medical groups urged Speaker of the House Representative John Boehner (R-OH) to include a provision in an upcoming bill that would delay the ICD-10 compliance date another two years. Meanwhile, last month, the Coalition sent a letter to House and Senate leaders urging them not to delay the ICD-10 implementation date again. Nevertheless, the physician-based AMA’s stance has been to stop ICD-10 all together.

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