This was a year full of healthcare information technology (HIT) news. Vendors worked hard to develop and upgrade products designed to be compatible with ICD-10 coding and make the transition easier.

But more importantly were the non-HIT developments. There were stories that shaped perceptions of ICD-10 coding and how it will be implemented. Here are my top five stories of 2011:

The Codapocalypse

There are two types of panic that are caused by ICD-10 coding:

1. Warnings that healthcare providers and payers aren't doing enough to make the ICD-10 compliance deadline of Oct. 1, 2013.
2. Warnings of how expensive and unproductive ICD-10 coding will be for healthcare providers

The first kind of panic dominated the early part of the year. But ICD-10 opponents picked up steam and became more adamant that ICD-10 was going to ruin medical practice.

The Wall Street Journal

Face it. There aren't a lot of ways to make ICD-10 coding interesting to non-healthcare professionals. But Anna Mathews found a way to do that when she introduced ICD-10's specificity to Wall Street Journal readers. She picked out a selection of humorous diagnoses. For example:

"The WHO, for instance, didn't see the need for 72 codes about injuries tied to birds. But American doctors whose patients run afoul of a duck (see codes), macaw (see codes), parrot (see codes), goose (see codes), turkey (see codes) or chicken (see codes) will be able to select from nine codes for each animal, notes George Alex, an official at the Advisory Board Co., a health-care research firm."

The reaction was amazing. Anyone inclined to mention ICD-10 in social networks linked to the article and called out their favorite wacky diagnosis. Even those not inclined to mention ICD-10 found a need to make a joke or two.

This didn't exactly put ICD-10 debate into the mainstream, but it gave opponents new ammunition. It became hard to find an anti-ICD-10 argument that didn't cite one the examples in Mathews' story. Unfortunately many of those arguments didn't add any new insight or substance to the debate. Just new punchlines.

AMA vigorous opposition

It was really hard to say whether the American Medical Association (AMA) will be able to kill ICD-10 coding. But its declaration of vigorous opposition reinvigorated debate. It also bolstered the Medical Group Management Association's (MGMA) dislike of ICD-10 coding.

The coverage of the opposition practically was ignored by the mainstream media. Only healthcare-focused publications seemed to care. Perhaps a sign of how much effect the AMA will have on this issue.

The CMS

The Centers for Medicare and Medicaid  Services (CMS) is the lead organization for making sure ICD-10 is implemented. Anything it does is important to healthcare providers.

For most of the year, it kept up a steady stream of education and guidance to keep healthcare organizations focused on ICD-10 implementations. But as the year came to a close, it announced a sort-of extension of the HIPAA 5010 deadline.

On Jan. 1, healthcare providers will need need to use the HIPAA 5010 standards for electronic claims if they want reimbursement. But the CMS will not enforce fines or penalties if they are not compliant. The effect of this is debatable.

Then Donald M. Berwick resigned as the head of CMS, and deputy administrator Marilyn Tavenner was named as his replacement. Which wasn't unexpected. Berwick's term was up at the end of the year due to the controversial nature of his appointment.

The political landscape

The U.S. Congress did nothing to affect ICD-10 implementation this year. So it's not an obvious selection. But the fight over the budget was combative and set the stage for massive cuts to come later. For example, President Obama pledged to cut about $1.9 billion in Medicare fraud.

And speaking of Obama, Republicans looked for ways to repeal Obamacare while the Supreme Court decided to decide the constitutionality of the universal mandate.

As these battles continue, ICD-10 implementation could become collateral damage.

Why these stories were important

They set the stage for what's going to happen in 2012. Decisions could be made that kill or delay ICD-10 implementation. Look for the second part of this analysis this week.