Crying “Uncle” in ICD-10 Implementation


I can recall as a child, we played this game called “Uncle,” but you may have called it playing “Mercy.”  In this game, we locked fingers and squeezed each other’s hands, bending them backward, inflicting as much pain as possible until the pain got too great and one opponent cried “Uncle.”  This meant the game ended and the silent opponent was the winner.

kids play mercyAs adults, the curious thing is that you can look back and recognize the facts, the same person usually won.  It was almost always the oldest of the group, or the strongest boy. It was always the person who had the greatest muscle behind them.

This is truly the current state of ICD-10 implementation, we’re engaged in a battle of “Uncle/Mercy”.  On one side — the AMA and the opponents of ICD-10, the other the “pro-ICD-I0” crowd.  The AMA delegates started their meeting on last Sunday with a boycott proposal of ICD-10.  I have to wonder where the logic is there.  You’ll be treating patients but not submitting the claims?   Not quite what you hope to accomplish, certainly not the best squeeze they could manage. Next they presented the “safe harbor” two year grace period — perhaps that is the forceful squeeze?  Dropping non-compliant providers, the tighter squeeze?  The other side is pushing equally hard, squeezing and pushing talking about risk management, better data, global sharing of information…squeezing and pushing, neither side really willing to give up.

Is it EHRs, revenue cycle, risk management, or global stewards of health and morbidity?  Is it unfair regulation, excessive documentation or a risk to patient care?  Who is right and who is stronger in this battle.  What will it take for us to finally cry “Uncle” and accept the changes we need to make in our clinical documentation?  And if you are on the side who refuses to yield, what will be the ramifications then?  In the game, you might have wound up with a broken finger or wrist perhaps.  What has to break in this battle before someone cries “Uncle”?

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