Legislators back transition to ICD-10

Members of the House Energy and Commerce Committee's Subcommittee on Health made clear at a hearing examining ICD-10 implementation Wednesday that they do not want to see the transition delayed yet again.

Rep. Joseph Pitts (R-Pa.) stressed that ICD-9 is more than 30 years old and therefore unable to capture the data needed to track changes in modern medical practice.

"Many providers and payers, including the Centers for Medicare & Medicaid Services, have already made considerable investments in the ICD-10 transition," Pitts added. "Any further delay will entail additional costs to keep ICD-9 systems current, to retrain employees and to prepare--again--for the transition."

Rep. Gene Green (D-Texas) agreed with Pitts. While he understands that the medical community has had mixed reactions to the transition--with some not ready to implement ICD-10 despite considerable expenses already paid--each delay has been costly to the healthcare system, he said.

"The ICD-10 transition is an important part of bringing our healthcare system into the 21st century," Green said.

Of seven witnesses who testified at the hearing, all but one--urologist William Jefferson Terry from Mobile, Alabama--supported going forward with the transition on Oct. 1. Terry cited the increased granularity in the new coding system as the primary reason why productivity would suffer, should the transition stand.

"There are 250 codes just for diabetes alone," Terry said. "Those who best understand ICD-10 and who are most prepared will see the lesser end of this increase, while those unprepared will have a tremendous stress placed upon them and their practices."

Terry added that the implementation model is flawed, saying that a hasty "big bang" transition has the potential to "do irreparable harm" to patients and physicians. He argued for legislators to look more closely at the possibility of a transition involving dual coding, saying that providers must be able to get paid if they encounter initial bumps in the road.

"Everybody can't run a 4-minute mile," Terry said. "Some doctors aren't going to be able to do it. Do they deserve a death sentence; to be put out of business?"

However, Edward Burke, who practices internal medicine in rural Missouri, said he has been ready for ICD-10 for years, primarily due to preparation.

"As the world becomes ever smaller, it is important to see healthcare with a broad view," Burke said. "We must be open to change and to the possibility that a different way can work. ICD-10 is truly better than what we currently have."

A Government Accountability Office report published last week concluded that CMS has taken positive steps to help the healthcare industry prepare for ICD-10, but GAO implored every organization--providers, payers and vendors--to prepare in advance to make the transition a success.

ICD10 Watch's Carl Natale also stressed in a recent post that medical practices must start working with both commercial and government-run payers now in order to be ready Oct. 1.

The American Hospital Association, in a statement published for the hearing, backed the assertion that ICD-10 implementation cannot be delayed again.

"In order to achieve a successful transition to ICD-10, the entire healthcare community--hospitals, physicians, payers, clearinghouses and government agencies--must stop debating the value of ICD-10 and take the needed actions to implement it successfully," AHA said. "We urge Congress to stop any proposal to further delay this needed coding update."

To learn more:
- check out the hearing materials (including video and statements)
- read Natale's post
- here's the AHA's statement (.pdf)

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