June 3, 2015

Headlines Generate False Hope


We’ve all heard the old adage that “the road to hell is paved with good intentions.” The recent headlines indicating that the American Medical Association (AMA) is pushing for another ICD-10 delay and that a bill with the same aim has been introduced in Congress are indicative of that notion. Already we’ve experienced physicians cancelling educational sessions because “the AMA is stopping ICD-10.” In addition, physicians have received numerous requests, from both those for and against ICD-10, to contact their representatives and senators. 


Regardless of the intent behind these communications, inaccuracies are being perceived as fact and physicians are becoming more and more confused by the mixed messages. Some don’t want to continue preparing in case their efforts will be for naught if there is another delay. Others believe that those who are still pushing them to prepare are not credible; after all, the headlines imply that implementation may not happen. On the other side of the coin, some physicians have said that a hospital told them there will be no issues, so they have disengaged based on hollow promises. 

For those physicians, practices, and entities that aren’t ready, the continuing barrage of questions regarding whether there may be another delay is counterproductive. Is it possible that a last-minute action by Congress could surprise all of us? Yes. Is it likely? No. I believe that if Congress was so inclined, the notion of another delay would have gained ground during the sustainable growth rate (SGR) fix. The more prevalent thought seems to be that there is far too much hinging on the new payment models to continue to delay ICD-10. 

So, what is the truth of the matter that should be told to physicians? The AMA is opposed to an Oct. 1, 2015 implementation. That is a fact. Another fact is that some physicians believe that this makes another delay a certainty. Although the AMA is a credible organization with valid goals and initiatives to support and help their members and other physicians, they alone do not control the implementation date. Physicians need to understand that while they may vehemently support the AMA position, it does not mean a delay is going to happen. Congress will receive just as many, if not more, communications supporting the Oct. 1 date from other organizations and physicians who do support implementation.

Other recent headlines noted that U.S. Sen. Poe had introduced H.R. 2126, the “Cutting Costly Codes Act of 2015,” to prohibit ICD-10 implementation. Our physicians who believe that this means the bill will pass a congressional vote will likely be very disappointed. The facts are that there will need to be a groundswell of support in both houses and the emergence of committee champions to move it forward. At least as of this moment, neither has happened and neither is expected to happen.

I think the message to our physicians and practices is not really different than what they would tell a patient or their family when it is obvious that the news is very bad and the odds of a recovery are slim. They don’t say that someone who is clearly dying is going to be fine. They tell the truth in a way that will be understood. They don’t give false hope even if the news is unwelcome.  They help the patient and their family prepare for whatever comes next.

Without a last-minute surprise, ICD-10 will happen on Oct. 1, 2015. This industry needs to focus on the facts and the whole story. Talk of these phantom additional delays gives false hope, which will cause far more problems for our providers. 

Holly Louie, RN, CHBME

Holly is the Compliance Officer for Practice Management Inc., a multi-specialty billing company in Boise, Idaho.  Holly is the 2016 President of the Healthcare Billing and Management Association (HBMA) and previously chaired the ICD-10 Committee.  Holly is also a national healthcare consultant and testifying expert on matters related to physician coding, billing and regulatory compliance.  She has previously held compliance officer positions in local and international billing companies. Holly is a member of the ICD10monitor editor board and is a popular guest on Talk Ten Tuesdays.

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