1. 2015;18;E107-E113First, Do No Harm by Adopting Evidence-Based Policy Initiatives: The Overselling of ICD-10 by Congress with High Expectations
   Health Policy Opinion
   Joshua A. Hirsch, MD, Standiford Helm II, MD, Frank J.E. Falco, MD, and Laxmaiah Manchikanti, MD.

As we just entered 2015, the health care system continues to undergo massive change with uncertainties among patients, payers, and providers. Among the major issues U.S. physicians and practices face are the seemingly endless cycle of impending sustainable growth rate (SGR) cuts and deadlines for International Classification of Diseases, Tenth Revision (ICD-10) implementation. In addition, physicians and practices face significant policy and marketplace changes, with hospitals, the insurance industry and information technology (IT) dominating the marketplace, often to the detriment of independent physician practices. As October 1 nears, once again Congress appears to be implementing another unfunded mandate that is not rigorously based on the evidence. ICD-10 implementation is based on a liberal interpretation of an inconspicuous provision in Title II (4) of the Health Insurance Portability and Accountability Act (HIPAA) regulating health care transactions, national identifiers, and health care fraud and abuse. Based on this, a January 2009 final ruling by the Department of Health and Human Services (HHS) decided that classification of diseases ICD-9 diagnosis and procedure codes must convert from using ICD-9 to ICD-10 on October 1, 2013.