Wednesday, May 16, 2012
This Week's News
This Week's News
One-year delay of massive ICD-10 code set not enough, AMA tells CMS
Pushing off implementation of the ICD-10 code set until Oct. 1, 2014, will not provide enough time to analyze the code set's appropriateness and impact or prepare for the massive transition, the AMA told the Centers for Medicare & Medicaid Services (CMS) in a letter last week.
The AMA sent the letter in response to CMS's proposal to delay implementation of the ICD-10 code set for a year beyond the original implementation deadline of Oct. 1, 2013. The AMA urged the agency to delay the deadline by at least one additional year, calling it a "necessary first step."
A two-year delay, the AMA argued, would allow time for CMS to conduct an in-depth analysis of the costs and benefits of implementing the new code set and engage all stakeholders in assessing the appropriateness of its implementation. The AMA has suggested that an "alternative code set approach" may be more beneficial than implementing the new code set in its entirety, noting that other countries that have adopted ICD-10 have adopted a modified version, often with government support.
The AMA asked CMS to postpone implementation of a new code set until all stakeholders agree upon a new approach, due to the complex nature of such a transition. The current code set uses 13,000 outpatient diagnostic codes, while ICD-10 would require physicians to contend with 68,000 of these codes—a fivefold increase. Based on Canada's experience with implementing ICD-10 and CMS's own assessment, physicians also would face significant disruptions in claims processing and payment.
"This is a massive administrative and financial undertaking for physicians, requiring education, software, coder training and testing with payers," AMA Executive Vice President and CEO James L. Madara, MD, wrote in the letter. "Depending on the size of a medical practice, the total cost of implementing ICD-10 ranges from $83,290 to more than $2.7 million."
In addition to the expense and complexity of the new code set, physicians would be required to adopt it at the same time they must comply with already competing health information technology programs recently initiated by CMS. In the letter, the AMA also requested better alignment of these programs.