Saturday, November 15, 2008

Family physicians oppose switch to ICD-10-CM

Much of the opposition to HHS' proposed rule to adopt ICD-10-CM is about the timeline. They have drunk the ICD-10-CM kool-aid, as it were, and simply ask for more time to make the switch from ICD-9-CM.

However, we recently uncovered opposition to switching at all. On behalf of the American Academy of Family Physicians (AAFP), Dr. Jim King writes a letter in response to the proposed rule.

Here are some highlights of the letter:

The AAFP does not support the transition to ICD-10-CM because we do not find that there is good rationale for making such a significant change.

The purported benefits of the transition to 68,000 ICD-10-CM diagnosis codes are largely based on assumptions and not supported with any real world trial involving practicing physicians in the United States.

Our recommendation that CMS not adopt ICD-10-CM is further supported with the following:
  • Enhancement and adoption of electronic health records (EHR) must come first
  • ICD-9-CM diagnosis codes meet the needs of patient care
  • Biosurveillance and research needs can be met through the mapping of ICD-9-CM to ICD-10-CM
  • Disease management programs are not dependent on diagnosis codes
  • CMS’s estimates of coding education needs are not accurate
  • Changes required for adoption of ICD-10 are substantial
  • Lack of resources to support physician adoption
The AAFP is the premier speciality society for family physicians. Dr. King is Chair of the Board of the AAFP.

The AAFP has been at the vanguard of electronic health record (EHR) adoption. They have been a key driving force behind the creation of health care information technology standards, including the continuity of care record and continuity of care document.

This opposition does not therefore come from a small, fringe group. Nor does it come from a group that is backwards in its thinking with respect to health care information technology.

The Centers for Medicare and Medicaid Services would do well to listen to those doctors who are at the forefront of using information technology to improve healthcare. They should drop their plan to switch to ICD-10-CM.

As a postscript, we note that in our third post, we criticized the AAFP for not opposing the switch. We hereby withdraw that criticism!

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