When Heritage Foundation joined the ICD-10 debate recently, it struck hard at what it considers to be "weak arguments" in favor of the code set conversion.

Now the Coalition for ICD-10 has stepped into the ring and taken a swing at Heritage. 

"The Heritage Foundation report is the latest attempt by special interest groups to block implementation of ICD-10. It’s the same tired arguments we’ve heard for the past 20 years," the Coalition for ICD-10 wrote in a document circulated on Friday. "The proposals put forth in the report would not only result in the loss of enormous investments that have already been made, but would require extraordinary additional investments."

The proposal to which the Coalition for ICD-10 refers would be Heritage’s rather bold suggestion that Congress both "delink the disparate goals of research and reimbursement," and instead of mandating ICD-10, "develop a more appropriate coding system that makes billing less, not more, burdensome."

"The Heritage Foundation proposes that we start over?" the Coalition for ICD-10 asked, rhetorically.

"How much longer must we wait for better measures and higher-quality information needed to improve patient care? To manage costs? To ensure fair payment?" memebers of the coalition wrote. "How many more millions of dollars will we be asked to divert to the creation and implementation of a ‘more appropriate’ coding system, which could be used for purchasing new patient care equipment, investing in clinical research, and hiring additional caregiver resources?"

In its document, Heritage took aim at several of the ICD-10 proponents arguments, in fact, looking to poke holes in the notion that ICD-9 is antiquated, that the U.S. needs ICD-10 because so many other developed nations are already there, and taking issue with the contention that ICD-10 will ultimately improve patient care.

The Coalition for ICD-10 countered that creating another diagnostic coding system would not reduce costs or ease doctors’ burdens but, rather, would be more expensive, particularly if healthcare entities have to maintain another classification system. And it aimed across the bow of those suggesting a dual-coding period after the Oct 1. 2015 compliance deadline, cautioning that such a transition period would adversely impact care quality.

"Hospitals, health plans, providers, researchers, coders, federal agencies, state agencies, vendors, device manufacturers, and more are overwhelmingly ready and have invested tens of billions of dollars to be ready," according to the coalition. "We must end two decades of delay tactics. It is time to move forward with ICD-10."

Who’s right? Who’s wrong? And which side are you on?