When it comes to ICD-10, a feeling of déjà vu is beginning to creep over me. Not only are interest groups both for and against the implementation out in full force, apparently another delay could be attached to a "must-pass" $157 billion spending bill for the departments of Labor, Education and Health and Human Services that expires next week.
Implementation, of course, was delayed in a similar fashion just eight months ago, when a provision was attached to a 12-month patch to the sustainable growth rate payment formula that prevented deep Medicare payment cuts to providers. That bill overwhelmingly passed through Congress before being immediately signed by President Obama.
That leads me to wonder: Will the U.S. ever see ICD-10?
All indications are that larger providers (hospitals and health systems) are prepared to make the transition. Smaller providers (standalone doctors and physicians' offices), however, continue to raise objections, including high costs and an overabundance of codes.
Advocates for ICD-10 argue that making the transition will enable more accurate coding. The eHealth Initiative has gone as far as to call ICD-10 compliance "mandatory" in order for health IT use to progress.
Opponents, such as the American Medical Association, have a different take.
"This is not the sky is falling, but boy, it sure does at times feel like it," AMA President-Elect Steven Stack said of the transition at a conference in October. He added that AMA's primary goal is not continuing to delay ICD-10 implementation, but killing it altogether.
So who's right?
Is ICD-10 really as invaluable as advocates claim to the success of health IT? After all, despite the fact that the proverbial can kicking has become somewhat of an annual event, new technology continues to be developed and adopted.
Or, is the updated code set as burdensome as detractors maintain? For instance, Carl Natale, author of Healthcare IT News' ICD10Watch, last month wrote that if the transition were somehow supplemented by the federal government, it wouldn't even be an issue.
"If Congress finds a way to fund implementation costs for small medical practices and independent physicians, we're going to be using ICD-10 codes this year," Natale said in a post. He added, however, that such a stimulus plan would require money to be siphoned from one program to another, which is always a tricky political proposition.
Readers, I'd like to hear what you think. Should ICD-10 be delayed, yet again (and is it doomed to bounce around as a rider on more significant legislation)? Is there a more viable alternative (perhaps a phase-in approach)? Should the transition be killed, altogether?
Or, will the industry actually go through with implementation, as currently planned?
At this point, I think I'd be most surprised by the latter. - Dan (@Dan_Bowman and @FierceHealthIT)