AMA Wire

Wednesday, June 5, 2013

This Week's News

Following House's lead, Senate introduces bill to repeal ICD-10

Following Houses lead, Senate introduces bill to repeal ICD-10

A bill seeking repeal of the ICD-10 code set is now in both chambers of Congress after its introduction to the U.S. Senate last month.

The Cutting Costly Codes Act of 2013, which was first introduced into the U.S. House of Representatives in April, would prohibit the U.S. Department of Health and Human Services from implementing, administering or enforcing current regulations that require the new code set to take effect Oct. 1, 2014. The bill was introduced to the Senate May 16 by Senators Tom Coburn, MD, R-Okla., John Barrasso, MD, R-Wyo., Rand Paul MD, R-Ky., and John Boozman, R-Ark.

In addition to repealing implementation of the ICD-10 code set, the legislation also would require a federal study on ways to mitigate the disruption any replacement of the ICD-9 code set would cause for physicians and other health care providers.

The AMA has voiced strong support for the legislation, including a formal letter sent to Rep. Ted Poe, R-Texas, the day he submitted the bill to the House.

"The differences between ICD-9 and ICD-10 are substantial, and physicians are overwhelmed with the prospect of the tremendous administrative and financial burdens of transitioning to the ICD-10 diagnosis code set with its 68,000 codes—a five-fold increase from the approximately 13,000 diagnosis codes currently in ICD-10," the letter states.

Experts say the new code set will affect not only claims submissions but also such processes as patient eligibility verification, pre-authorization for services, documentation of patient visits, research activities, and public health and quality reporting. The cost for individual physician practices to adopt ICD-10 is estimated to be around $83,000 for a small practice and as much as $2.7 million for a large group practice.

At the same time, physicians should make preparations for the new code set to avoid disastrous results if ICD-10 is rolled out as planned. Those who aren't ready by next year's deadline will not receive payment for their services. Resources to help physicians prepare are available on the AMA's ICD-10 Web page and through the AMA Store.

The AMA will continue to work with members of Congress toward a solution to ensure physicians' practices are not disrupted as the result of implementation of a new code set.