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ICD-10 Coalition Fires Back at AMA Remarks on New Codes

By Jennifer Bresnick

The Coalition for ICD-10 responds to continued resistance from the American Medical Association.

- “Injured in a lightsaber duel” may not be among the handful of quirky codes included in the tens of thousands of new ICD-10 identifiers, but the addition might be necessary following American Medical Association (AMA) President Dr. Robert Wah’s recent remarks lampooning some of the stranger options within the code set.  After making a reference to the popular Star Wars franchise during a speech to the AMA House of Delegates, the Coalition for ICD-10 took issue with Wah’s derision of the comprehensive update, and supplied a number of counter arguments.

“If it was a droid, ICD-10 would serve Darth Vader… For more than a decade, the AMA kept ICD-10 at bay – and we want to freeze it in carbonite!  Sucked into a jet engine? Burned by flaming water skis? Yes, there are codes for that,” Wah, a self-professed Star Wars fan who joked about his nickname of “Obi-Wah-Kenobi” as an OB-GYN intern, said in his speech.

But Wah was unable to play any Jedi mind tricks on the Coalition, which was not amused by his attempts at levity.  “Dr. Wah’s attempt at humor is unfortunate because the quality and precision of our national health care 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 Coalition’s response states. “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 Yet we continue to rely on an outdated 1970s-era coding system for reporting diagnoses and inpatient hospital procedures.”

Noting the importance of seemingly strange codes to areas of medical practice such as worker’s compensation and the Department of Defense, the Coalition adds that these codes don’t pose a burden for physicians who will rarely, if ever, be required to use them.  “This is like saying the English language is a burden to use because there are 470,000 words in Webster’s unabridged English dictionary,” says the statement. “Just as no one is expected to know rarely used words like floccinaucinihilipilification… physicians and other providers will only use the codes relevant to their patient population (e.g., an ophthalmologist will primarily use only the eye codes).”

The Coalition goes on to state that emerging health issues such as Ebola and concussions among youth sports players cannot be coded in ICD-9, and adds that the rest of the world has long since moved on to the more complete, detailed, and advanced code set.  ICD-9 is unable to identify a number of common issues such as complications and potential quality problems, and is not current with new advances in procedures and newly identified diseases.

“How can we as a nation assess hospital outcomes, pay fairly, ensure accurate performance reports, and embrace value-based care if our coded data doesn’t provide such basic information?” the Coalition asks. “Doesn’t the public have a right to know this kind of information?”

ICD-10 may not be the code set the AMA is looking for, but one thing is immediately clear: October 1, 2015 is anything but far, far away.  Providers who wish to be prepared for the implementation of the ICD-10 code set within the next year should continue to move through their transition timelines in an appropriate manner to avoid potentially negative revenue impacts should the update go ahead as planned in 2015.

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