100 physician groups call for contingency plans for ICD-10 transition

The American Medical Association (AMA) and 99 state and specialty societies urged the Centers for Medicare and Medicaid Services (CMS) today to address several of their concerns about the potential impact of the transition to the ICD-10 code set. The groups are worried there are not sufficient contingency plans in place to avoid anticipated failures that could result in a significant, multi-billion dollar disruption for physicians and serious access to care issues for Medicare patients.

Recently released end-to-end testing results showed that the claims acceptance rate would fall from 97 percent to 81 percent if ICD-10 was implemented today. That change in Medicare’s acceptance rate could potentially cause a catastrophic backlog of millions of unpaid Medicare claims. Because the testing only represents less than one percent of all Medicare claims and likely involved providers who are significantly more prepared for ICD-10 than many of their peers, the acceptance rate could actually be much worse.