Claims Processing

ICD-10 financially disastrous for physicians, AMA tells HHS

. 2 MIN READ

Citing dramatically high costs and interference with quality improvements, the AMA on Wednesday continued its efforts to stop ICD-10 implementation in a letter urging U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius to reconsider the mandated transition to the new code set, currently scheduled for Oct. 1.

In the letter, AMA CEO and Executive Vice President James L. Madara, MD, outlines the considerable drawbacks of requiring physicians to comply with the new code set by the Oct. 1 deadline.

“Physicians are being asked to assume this burdensome requirement at the same time they are being required to adopt new technology, re-engineer workflow and reform the way they deliver care; all of which are interfering with their ability to care for patients and make investments to improve quality,” Dr. Madara said in the letter.

According to an AMA study released Wednesday, the cost to meet the ICD-10 requirements is dramatically higher than previously estimated. A small physician practice, for instance, can expect to spend anywhere from $56,639 to $226,105 to prepare for the new code set.

The letter emphasizes that ICD-10 implementation will be financially disastrous for physicians and impede progress to a performance-based environment. 

“Given the significant cash flow interruptions stemming from previous Health Insurance Portability and Accountability Act (HIPAA) mandates, we expect the financial impact of ICD-10 on physicians will continue well beyond the Oct. 1, 2014, implementation date,” the letter states.

Meanwhile, the absence of true end-to-end testing means physicians will be able to determine only whether their claim will be received—no information will be given about whether the claim will be paid, how much will be paid or whether the correct code was used in the limited testing the agency has agreed to facilitate.

“Adopting ICD-10 … is unlikely to improve the care physicians provide their patients and takes valuable resources away from implementing delivery reforms and health information technology,” the letter states.

FEATURED STORIES