A coalition of 15 stakeholders including technology associations, insurers, vendors, advocacy organizations and one delivery system recently sent a letter to congressional leaders opposing any further delays to the ICD-10 compliance date.

That the Coalition for ICD-10 lacks representation from physician groups did not get past Lloyd Van Winkle, M.D., a solo family doctor for nearly 30 years in rural Castroville, Texas. “I’ve been watching ICD-10 as it pushes forward and tries to come into my life,” he tells Health Data Management. “I’m concerned that it may be premature. I’m trying to keep my practice afloat and question if this is a valuable instrument.”

From Van Winkle’s perspective, the coalition is a group of organizations trying to make money off of ICD-10, particularly insurers who see the code set as an opportunity to further reduce payments. None of his payers, he adds, has reached out to test.

ICD-10, he contends, is another attempt to whittle away the livelihood of physicians, especially small family practices which are the front lines of medicine. “You take away another five or six percent of their bottom line and some of these doctors will go under.”

ICD-10 is good for data miners, data collectors and payers, but not for practicing physicians in the trenches, he contends. It will ensure that many practices won’t get paid for months once the compliance date hits and those who want to survive will have to dig into their retirement accounts. “If someone comes out with a new treatment for diabetes or migraines, doctors would be all over that. But ICD-10 is not about the day-to-day care of patients.”

Whether the ICD-10 rollout will be successful is a crapshoot and a hope, Winkler believes.  Providers may spend months preparing and not be rewarded for it. He likens it to studying to go skydiving for the first time, and you won’t really know if everything is okay until you jump out of the plane and the parachute opens.

A nationwide rollout on a specific data of the new code set makes no sense, Winkler says. ICD-10 should be rolled out in a small state first with practices offered a line of credit, then run the codes for a year and fix problems before making it live for the entire country.

Physicians are the forgotten part of ICD-10, he asserts. “I’ll put up with a lot to be a country doctor—to go in the office at night to sew up a finger cut in a saw. Why are you making me pay for your data collection activities? Why are you making patients pay? Just let me be a doctor. If ICD-10 is so important, then roll it out for a year in a test market.”

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