Updated on: March 17, 2016

ICD-10 and Twitter: Characters Abound

Original story posted on: June 2, 2014

One hundred and forty characters in Twitter; seven (spaces) characters in the procedure coding system (PCS) of ICD-10; and, in between, a variegated universe of tweets, tweeters, and followers give rise to the notion that the use of social media, notably Twitter, the electronic lingua franca, might be fostering a cultural divide in the healthcare space.


“Twitter went from being a place where information and critical discussion took place to more of a dumping ground for bad jokes about flaming water skis and lobbying against the mandate,” wrote Steve Sisko in an email to ICD10monitor. Sisko, a senior IT project manager for Cambia Health Solutions, noted that many of the tweets leading up the latest delay of ICD-10 were coming from those who were misinformed on the proposed coding system.

“Many clearly ignorant comments were widely tweeted,” Sisko noted. “Such as ‘ICD-10 is part of the Affordable Care Act (ACA),’ ‘Physicians have to know all the codes,’ and confusion between ICD-CM (diagnoses) and ICD-PCS (procedures).”

During the run-up to the Senate vote on March 31 that postponed the compliance date until not before 2015, the popular hashtag #ICD10 was used to disseminate information about I-10, not disparage the coding system or discourage its adoption.

“Prior to the recent sustainable growth rate (SGR) fix bill that included language to delay ICD-10 until at least Oct. 1, 2015, the #ICD10 hashtag was mostly informational,” wrote well-known tweeter Brad Justus with Kforce Healthcare. “This changed during the massive social spike started by the American Health Information Management Association (AHIMA) and their #NoDelay hashtag and Tweet Chat days before the vote.”

Justus believes social media might have galvanized people new to social media who were both in favor and against implementing ICD-10.

“Many passionate people for and against ICD-10 who had never been involved in social media started to engage,” wrote Justus. “A clear line was defined around arguments for and against, and extreme passion was demonstrated.”

Justus believes today that since the delay, the messages have toned down, but not necessarily the division between the two sides: “The line is more clear,” Justus asserts.

“No matter what happens, social media will definitely play a role in the ICD-10 date and compliance moving forward,” Justus wrote.

Who seems to have a larger share of voice in the debate? According to management and technology consultant Joe Lavelle, those who are actively engaged in social media tend to be more in favor of ICD-10 than others who are not.

“It seems that the ICD-10 social media community is strongly in support of ICD-10,” wrote Lavelle in an email to ICD10monitor, noting the exception of the American Medical Association (AMA) and Medical Group Management Association (MGMA). “I am trying to find ways to communicate with those that do not participate in social media. I don’t think that we can assume that their silence means they are in agreement with either side of the argument.”

Lavelle raises the question as to why the social media community is reaching out to both organizations.

“I am curious why, in social media, and otherwise, we are not addressing AMA’s and MGMA’s concerns head-on,” wrote Lavelle. Looking for a possible solution, Lavelle suggests “engaging with those organizations in a productive dialogue that might move the needle toward a compromise that would be acceptable toward both organizations.”

According to George Vancore with BlueCross BlueShield of Florida, the range of emotional reaction to the ICD-10 delay has been across the board.

“The reaction to the ICD-10 delay has been varied and quite emotional at times,” Vancore wrote in an email to ICD10monitor. “Reactions have spanned the spectrum from shock to anger to relief with most folks eventually landing on acceptance.”

As a health plan director, Vancore’s focus is on collaboration among stakeholders. He sees social media playing a significant role.

“(Although) there has been a lot of great work done to date across the healthcare industry in getting prepared for ICD-10, we are finding, however, that the greatest work seems to center more and more on industry collaboration between physicians, providers, health plans, clearinghouses, vendors, and other constituents,” Vancore wrote. “This will be Florida Blue’s focus going forward; we cannot and should not do ICD-10 alone—we really can’t, and we really need each other in this one; as an industry, that is where we have failed in the past.”

To his credit, Vancore has deployed several key initiatives. He wrote that his organization would continue its “Open-Line” Friday teleconference calls that it started during the 5010 transition. Today, he notes the focus is on ICD-10.

“This one-hour monthly call utilizes a panel format with invited guest speakers like Dr. Joe Nichols; Stanley Nachimson; Sid Hebert from Humana; Shirley Reynolds from UHC, and Richard Owens from WellCare to discuss topics related to implementing ICD-10,” Vancore wrote. “Our panel is made up of representatives from the Mayo Clinic; Tampa General Hospital; SecureEDI; The SSI Group; Availity; Baptist Health South Florida; and the Spring Hills Family Practice located in Tampa Florida.”

While continuing to utilize traditional communication channels and medical associations and societies to “get the messages out,” Vancore acknowledges, the approach has not necessarily provided enough reach the past.

“If we continue to do the things that we have always done, then we will continue to get what we have always gotten,” Vancore wrote, explaining that the health plan will “leverage a social media channel to extend our reach, get the message out, and engage new collaborative partners and participants.”

Vancore believes this approach is working and that interest, he says, is going in the right direction “dramatically.”

“Our approach going forward will continue to be one of collaboration with other health plans and electronic trading partners in order to gain agreement, engagement, and synergies with our physicians and providers across the industry; not just for Florida Blue or even for compliance reasons,” Vancore wrote. “We do this for our patients and members whom we all serve across the health care spectrum.”

Concludes Vancore, “We need to make this work, and using social media to help is working!”

Program Announcement: Tune into Talk Ten Tuesdays today at 10 ET to hear more from Brad, Steve, Joe and George on using social media to move forward with ICD-10 implementation. Please tweet your questions or comments to #ICD10 so we can discuss them during our roundtable segment and in a follow-up story. Register for Talk Ten Tuesdays, here.


Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.
Chuck Buck

Chuck Buck is the publisher of ICD10monitor and is the executive producer and program host of Talk Ten Tuesdays.