In some quarters, vigorous opposition to ICD-10 implementation is turning into guerrilla warfare.

The Texas Medical Association is encouraging physicians to lobby Congress for a two-year ICD-10 delay. They even provide the text that physicians should cut and paste onto their personal stationery.

The TMA letter cites the number of ICD-10 codes, costs, reimbursement delays and competing federal mandates. Nothing new here.

It's the call to action that I find interesting:

"Please tell Speaker Boehner, Chairman Fred Upton, and Chairman Pete Sessions that you want to add the ICD-10 delay to a must-pass piece of legislation during the upcoming 2014 lame duck session."

This is how the Protecting Access to Medicare Act of 2014 became the vehicle to delay ICD-10 implementation earlier this year. It could work again, because there might not be anyone in Congress who cares enough about ICD-10 implementation to try to strip out any anti-ICD-10 amendments.
But maybe that will change. The ICD-10 Coalition has its own letter urging Congress to keep ICD-10 on track. Unfortunately, I'm not sure such letters have any effect beyond being able to say the authors are on record for or against issues.

[See also: ICD-10 delay rattles industry groups.] and [How did ICD-10 get into SGR bill?]

The American Health Information Management Association took to Twitter to rev up its #ICD10Matters campaign. Social media campaigns are the 21st Century version of TMA's letters. The AHIMA effort also reminded Congress of its upcoming information-sharing session on Capitol Hill this fall.

And that's not the only way AHIMA is fighting fire with fire. Its own analysis of ICD-10 costs seeks to counter the fears physicians have about how much the ICD-10 transition will cost. Unfortunately, it appears a little thin compared to the Nachimson Advisors report — which it seems to marginalize. Understandably, Stanley Nachimson hits back with a statement explaining why the new ICD-10 cost analysis is wrong.
 
The Nachimson rebuttal emphasizes its assessment of productivity loss for physicians in small practices -- which he suggests is about 10 percent. That's something you never see the American Medical Association (AMA) quoting.

So be on the lookout for the next piece of healthcare legislation going up before Congress. It might become the next battle for ICD-10 survival.