Electronic Health Records

ICD-10 elimination bill introduced in the Senate

Not satisfied with Republican Congressman Ted Poe’s efforts to stop ICD-10 by introducing a bill to the House of Representatives last month, Senator Tom Coburn (R-Oklahoma) has put forward the same bill, the Cutting Costly Codes Act of 2013, in the Senate.  Poe’s version, which followed an impassioned screed against the new code set on the House floor, was referred to committee, and has a low chance of ever coming to a vote.

Unlike Poe, Sen. Coburn is a physician with experience in general surgery, obstetrics, and family practice, and states in an accompanying white paper that ICD-10 is “filled with redundancies and unnecessary intricacies.”  He believes that physicians will “devote more time and energy toward coding, which may detract from patient care.”  Claiming there are uncertain benefits to implementing the vastly more detailed code set, he writes that “it is hard to imagine that increasing the number of codes from 18,000 to 140,000 would simplify billing and reduce errors. To the contrary, it would seem very plausible that more coding options coupled with greater coding specificity would foster tremendous confusion amongst busy providers, which would likely increase – not decrease – the amount of miscoded and rejected claims.”

While it’s unclear why Sen. Coburn believes that physicians aren’t mentally up to the task of accurately documenting the diagnoses that they are making anyway, he takes the common tack of mocking some of the more obscure ICD-10 codes, such as being struck by a turtle or being injured while on flaming water skis.  “The adoption of 140,000 billing codes fraught with nuances, superfluous intricacies, absurdities, and redundancies could serve as a major distraction to physicians and other providers who are trying to provide the best care possible,” he says.

The Senator suggests that Congress should get involved with discussing the risks and benefits of ICD-10, and asks HHS to take another look at going forward with implementation while physicians are facing so many regulatory burdens and high costs from other healthcare issues.  “What is a better implementation date for ICD-10? Never – or at least not until other systemic steps are taken to reduce administrative burdens, lower costs, and improve quality,” Coburn concludes.

While it’s not very likely that his legislation will pass, considering the Obama Administration’s focus on modernizing and advancing health IT and its associated initiatives, Coburn is correct in saying that there are widespread worries over ICD-10 that should be monitored and can be mitigated before October 1, 2014 rolls around.

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