Nicolet Araujo, RHIA with Brian Alesi, legislative
assistant to Rep. Dana Rohrabacher (CA-48).

EDITOR’S NOTE: Yesterday on “Talk-Ten-Tuesday,” Margarita Valdez, the principal representative of AHIMA with the United States Congress, told audience members that 200 representatives from 45 affiliated state organizations arrived on Capitol Hill for the association’s 12th annual Hill Day to meet with their respective Congressional representatives. Currently there are two legislative challenges facing ICD-10 implementation: HR 1701, the Cutting Costly Codes Act, introduced April 24, 2013, and S. 972, the Cutting Costly Codes Act, introduced May 16, 2013. Both bills would prohibit the Secretary of Health and Human Services from replacing ICD-9-CM with ICD-10-CM and ICD-10-PCS. Brian Alesi, legislative assistant to Rep. Dana Rohrabacher (CA-48).

On March 17 and 18, a group of passionate, interested members of the American Health Information Management Association (AHIMA) descended upon Washington, D.C., to spend time getting a better understanding of the exciting direction our AHIMA organization is headed and how we, as HIM professionals, can support this direction and get on board for the journey. We participated in the 2014 Leadership and Advocacy Symposium on March 17 and Hill Day, March 18. The Leadership and Advocacy Symposium was a one-day collaborative educational conference that brought AHIMA’s leadership together, with more than 40 states represented, to engage in dialogue that set the strategic direction and advocacy efforts of the HIM profession and the Association. Hill Day provided participating members the opportunity to interact and advocate for HIM with their congressmen and –women and corresponding legislative aides.

This was an optimal time for AHIMA’s HIM professionals to make inroads on key issues impacting our profession. Members divided into groups and, using the underground tunnel system, hustled from appointment to appointment between the Rayburn, Cannon, and Longworth House buildings as well as the Russell, Dirksen, and Hart Senate buildings. We found the legislative aides we met with to be very receptive to us as both constituents and professionals who should be part of the decision-making process for healthcare-related legislation. In many instances, the bulk of the time was spent in educating the legislative aides on specific bills that were pending and the potential impact of those bills on the world we both work and live in.

Specific bills of concern this year included HR1701 and its companion Senate Bill 972, both entitled the “Cutting Costly Codes Act,” introduced by Rep. Ted Poe (TX) and Sen. Tom Coburn (OK). These bills are designed to further delay the implementation of ICD-10 by prohibiting the Secretary of Health and Human Services from replacing ICD-9 with ICD-10. As is often the case within our political arena, “interested parties” have also lobbied to tack on unrelated and equally inflammatory language as amendments to unrelated bills as further attempts to quash this country’s transition to ICD-10. An example of this can be found with the appropriation bills and the SGR Repeal and Medicare Provider Payment Modernization Act of 2014. As you can see, it is imperative for our profession to vocalize why ICD-10 is important now, to avoid further administrative or legislative delays. AHIMA professionals found they were met with the usual arguments of “too costly,” “weird, unnecessary codes,” and “too many new codes.”

Discussions ensued about the inappropriate combining of costs associated with EHR implementation and ICD-10—two separate projects/endeavors. We educated legislative aides on the reality that most providers will only use a subset of all of the new ICD-10 codes and thereby have an attainable amount of new information to digest. Lastly, we tackled the infamous external cause codes, such as “getting pecked by a turkey.” We explained to the aides that these codes existed in ICD-9 and that additions to them in ICD-10 make up only a minority of the “new codes.” We also shared with them the need for these codes for externally mandated reporting for studies that have brought us life-saving legislation such as seat belt and helmet laws.

Lastly, we rounded out our discussions with the ever-present “call to action” regarding the need to lower the cost of healthcare and how ICD-10 provides one avenue of pursuit of this cause. We noted that, over time, ICD-10 will lower costs by preventing fraud, waste, and abuse, and increasing administrative efficiencies. Furthermore, we noted that every code in ICD-10-CM/PCS is strictly defined and will provide a mechanism for healthcare providers to be reimbursed only for the specific service(s) provided. Next, we spoke of the need for detailed data to provide significant improvements in quality measurement, public health monitoring, and research, which will save resources over time and improve quality of care. Our discussions always ended on the same note: that significant investments have already been made to transition to ICD-10. As many put it, the train has left the station and there is no going back!

With more than 72,000 members and 12,000 student members, AHIMA presents as a compelling voice to be heard. I believe that this year, again, Hill Day was a great success, both in terms of offering up AHIMA as a concerned party and resource to our congressmen and by engaging our members to actively participate in shaping the future of where we work as well as where we live: healthcare today. I encourage each and every reader to get involved. Get to know your member of Congress. Sign up for their newsletter. Go onto and and find out who is representing you and reach out to them and share your interests… be heard.

About the Author

Nicolet Araujo is a principal for the firm of PCG, providing ICD-10 and data governance transformation advisement resources and in the form of gap and impact analyses, project development and management as well as executive and provider education. Ms. Araujo is active in professional associations, serving in leadership roles on both a state and national level.

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