AMA's long war of words against ICD-10

'If it was a droid, ICD-10 would serve Darth Vader'
By Mike Miliard
04:14 PM
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One of the more notable things about the Centers for Medicare & Medicaid Services' revisions to its ICD-10 policy on Monday is the fact that the suggestions come straight from the AMA. After all, there's been no love lost between the two organizations when it comes to that subject these past few years.

[See also: AMA: Freeze ICD-10 in carbonite!]

Back in November 2011, for instance, AMA put the case as plainly as possible: "Stop the Implementation of ICD-10."

Putting its money where its mouth was, AMA's House of Delegates voted to "work vigorously" to make that happen.

Why? Because the ICD-10 switchover "will create significant burdens on the practice of medicine with no direct benefit to individual patients' care," said then AMA president Peter W. Carmel, MD. "At a time when we are working to get the best value possible for our health care dollar, this massive and expensive undertaking will add administrative expense and create unnecessary workflow disruptions.

"The timing could not be worse as many physicians are working to implement electronic health records into their practices," he added.

A couple years later, in June 2013, HIMSS Media's longtime ICD-10 Watcher Carl Natale covered another delegates meeting. And once again, their attitude toward those 68,000 new codes could be boiled down to two letters: N-O.

"Our AMA will immediately reiterate to the Centers for Medicare & Medicaid Services that the burdens imposed by ICD-10 will force many physicians in small practices out of business," the House of Delegates averred. "This communication will be sent to all in Congress and displayed prominently on our AMA website."

Natale called it as he saw it: "It looks like they're recommending physicians cover their ears and scream, 'Nah nah nah nah nah nah nah nah nah nah.'"

In February 2014, as the original ICD-10 deadline was eight months away (this, of course just a couple months before Congress' surprise compliance date delay), AMA once again made its case: "ICD-10 is Financially Disastrous for Physicians":

"Many practicing physicians regard ICD-10 as a costly, unfunded mandate that will not improve patient care. Indeed, the cost to meet ICD-10 is much larger than originally estimated. ... The AMA strongly urges CMS to reconsider the ICD-10 mandate."

A few months later, in November of that year, AMA President Robert Wah, MD, unleashed what to this date (or to these ears, at least) is the ne plus ultra of creatively-phrased anti-ICD invective.

"Here’s an interesting fact: Each of the six Star Wars films has this line: 'I have a bad feeling about this," said Wah in a speech to AMA board members and delegates. "That’s a common reaction to ICD-10. If it was a droid, ICD-10 would serve Darth Vader."

And he added a sequel to the Star Wars-themed jibes: "For more than a decade, the AMA kept ICD-10 at bay – and we want to freeze it in carbonite!"

This spring, as the 2015 looked more and more certain to be a certainty, AMA President Steven Stack spoke with Healthcare Finance News Associate Editor Susan Morse. "ICD-10 is problematic, it requires a level of specificity and precision clinicians say we don’t think we’re going to be able to provide," he told her.

He also suggested that AMA was planning to keep up its efforts to get Capitol Hill to see things its way – even at this late date: "There’s an eternity between now and October in legislative parlance," said Stack.

Whether Monday's news will be satisfactory at last to AMA, remains to be seen. As recently as late June, the group was reiterating that its members "remain steadfast in our belief that the ICD-10 coding system offers no real advantages to physicians and our patients – and certainly no advantages to justify the time and expense the entire health care system has invested in this transition.

"Even if ICD-10 were 'the best thing since sliced bread,'" officials argued, "its forced implementation would not be worth the extensive disruptions in patient care that surely will come without the grace period."