Policy & Regulation News

4 State Medical Societies to CMS: ICD-10 Offers No Advantage

By Jacqueline DiChiara

- Consider the most delicious slice of freshly baked Parisian bread you will ever stumble across in your life. Now consider it just far too costly and time consuming to happily sink your teeth into. According to the nation’s 4 largest state medical societies, “even if ICD-10 implementation were ‘the very best thing since sliced bread,’” its forced implementation is simply not worth the costs, nor the extensive disruptions and lagging productivity.

ICD-10 delay

In a letter last week addressed to Andy Slavitt, Acting Administrator of the Centers for Medicare & Medicaid Services (CMS), Luther F. Cobb, MD, President of the California Medical Association, Corey Howard, MD, Chair of the Florida Delegation to the AMA, Joseph R. Maldonado, Jr, MD, MSc, MBA, DipEBHC, President of the Medical Society of the State of New York, and David Henkes, MD, Chair of the Texas Delegation to the AMA (Cobb, et al), request Slavitt’s help in protecting the viability of both physician practices and patients. The 4 state medical groups, representing a combined 125,000 member physicians and medical students, declare to CMS there are no real benefits of ICD-10 implementation come October and push recommended actions from CMS to better advance the healthcare industry.

There are ‘no real advantages’ to ICD-10

“We remain steadfast in our belief that the ICD-10 coding system offers no real advantages to physicians and our patients — and certainly no advantages to justify the time and expense the entire health care system has invested in this transition,” the letter states. “The reduced productivity alone will cost physician practices hundreds of thousands of dollars and extend patient waiting times,” Cobb, et al, maintain.

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  • Referring to the mandatory ICD-10-CM implementation deadline of October 1 as a rather blatantly described “looming disaster,” Cobb, et al, confirm CMS’s end-to-end testing results do not create an aura of confidence amongst the healthcare industry. Financial bankruptcy is a substantial concern, even for those practices that are most prepared, the letter confirms. The “realistic” prospect of both denied claims and significantly delayed claims means many smaller practices will possibly be forced to close their doors, the letter implies.

    Indeed, the conversion to ICD-10 this fall may be the largest financial disaster ever for the healthcare industry, according to RevCycleIntelligence.com. Over half of healthcare providers confirm detrimental revenue cycle and cash flow concern in relation to CMS’s “successful” testing results, according to RevCycleIntelligence.com.

    “The results of the recent end-to-end tests give us little confidence that the nation’s physicians, electronic health records, claims clearinghouses, commercial insurance companies, and government agencies will be ready when we ‘throw the switch’ to ICD-10,” maintain Cobb, et al. “The voluminous technical problems associated with the far simpler adoption of the National Provider Identifier and the HIPAA 5010 transaction standards give us even further cause for concern,” they confirm.

    4 recommendations for CMS to consider and implement

    Regarding the House’s recent proposal of a 2-year ICD-10 grace period, Cobb, et al, maintain an extended period of transition would prove amply beneficial. It will allow for more on-the-job learning by physicians and for improved educational activities, they say. The arduous transition associated with handling an overwhelmingly complicated system will therefore be much less disastrous, the letter states.

    The letter urges CMS to take specific steps before October 1. First proposed is the aforementioned 2-year period that would mean physicians are not penalized for errors, mistakes, and system malfunctions. During this 2-year period, physicians should not be subject to RAC audits related to ICD-10-based coding mistakes, the letter states. Also, physician payments would not decrease or be withheld based on mistakes. And, in the event that claims are delayed, advanced payments should be administered, the letter says. “We stand ready to work with you, the administration, and Congress to help you achieve this tremendously important goal,” claim the 4 state medical societies.