Evidence that using upper-case 'O' and lower-case 'l' in ICD-10-CM codes is a big mistake

In a study of the accuracy of ICD-10-CM coding, a key "lesson learned" is that:  Coders often confused the number "0" (zero) with the letter "0", and the number "1" (one) with the letter "l".

This "lesson learned" should have been fully expected.  Dr. Vergil Slee and colleagues knew this problem would occur over 13 years ago in their book The Endangered Medical Record.

ICD-10-CM is a boondoggle.  We should not switch.

Oklahoma Senator files bill to stop the switch

Sen. Tom Coburn (Oklahoma) has introduced in the U.S. Senate a version of the Cutting Costly Codes Act of 2013.  This bill would block HHS from implementing the ICD-10-CM on October 1, 2014.  This action follows the filing of a similar bill in the U.S. House by a Texas congressman. 

Many of Dr. Coburn's physician colleagues in the U.S. Senate have signed on as co-sponsors of the bill.

They are correct. We should stop the switch.

Texas congressman introduces bill to stop the Switch

Texas Congressman Ted Poe has introduced the "Cutting Costly Codes Act of 2013" (HR 1701), which would put a halt to the switch to ICD-10-CM.  It is a good idea, and merits passage and signature by the President.

Doctors' organizations aligned against the switch

Led by the American Medical Association, 82 doctors' organizations have written a letter (PDF) to the Secretary of Health and Human Services opposing the switch to ICD-10-CM.  The letter was signed by 42 state medical societies and 40 specialty-specific medical societies, including the largest states (California, Texas, Florida) and most prestigious specialty societies (American College of Cardiology, American Academy of Ophthalmology, and the American Academy of Family Physicians).

The reason physicians oppose the switch is that it provides no direct benefit to patient care and the switch is only one of many regulatory burdens recently imposed by the federal government and physicians are having trouble managing them all at once.  ICD-10 is an administrative code set that supports payment for health care: it is on the "back end" and thus does not impact patient care at all, let alone favorably.  The burden of the switch is thus a net negative in doctors caring for patients, because it is costly and distracting.  The other regulatory burdens the letter calls out are (1) implementation of electronic health records to meet "meaningful use" criteria, (2) electronic prescribing, and (3) mandatory participation in the Physician Quality Reporting System (PQRS) and value-based modifier programs.

Physicians are correct.  The cost of the switch outweighs its benefits and it ought to be halted.

Ill-formed ICD-10-CM codes causing coding problems, as predicted nearly 13 years ago

Dr. Vergil Slee and his co-authors predicted in their 2000 book The Endangered Medical Record that the use of capital 'I' and lower-case 'o' in ICD-10-CM codes would cause confusion (with the numeral '1' and the numeral '0', respectively).

That prediction has come true.  Annie Boynton, director of provider regulatory compliance (ICD-10) communication, adoption and training for UnitedHealth Group, says that problems such as distinguishing between the letter “o” and the number zero and “1” and “I” result in incorrect and partial coding.

That and other technical issues with ICD-10-CM make it an antiquated system to which we should not switch!