AMA Backs House Bill Aimed to Freeze ICD-10 Implementation
By - Earlier this month, the House proposed a new bill, H.R. 2126, the Cutting Costly Codes Act of 2015, aimed at freezing ICD-10 CM/PCS implementation. The bill intends to prohibit Sylvia M. Burwell, Secretary of the Department of Health and Human Services (HHS), from substituting the currently implemented International Classification of Diseases, 9th revision (ICD-9) diagnostic code set with ICD-10. H.R. 2126 additionally mandates the Government Accountability Office (GAO) to execute research on how to best alleviate the financial burden of this decision on healthcare providers.
Officials from the American Medical Association (AMA) have voiced fervent support for this legislative push. James L. Madara, MD, AMA CEO and Executive Vice President, confirmed backing of the bill in a recent letter to Representative Ted Poe (R-TX-2).
“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 ICD-10,” Madara states, in reference to ICD-10’s 68,000 codes as opposed to ICD-9’s 13,000. “Implementation will not only affect physician claims submission,” he confirms. “[It] will impact most business processes within a physician’s practice, including verifying patient eligibility, obtaining pre-authorization for services, documentation of the patient’s visit, research activities, public health reporting, and quality reporting,” he adds.
Madara additionally confirms physicians will experience noteworthy claims processing and payment disruption while transitioning to ICD-10. Physicians will not get paid if they cannot smoothly execute this transition, he confirms.
“The timing of the ICD-10 transition could not be worse as many physicians are currently spending significant time and resources implementing electronic health records (EHRs) into their practices and adopting new payment and delivery models,” Madara explains. “Managing the change to ICD-10 at the same time as these care innovations may force physicians to choose to update their code set in order to get paid over improving the quality of patient care.” The bill is indeed “prudent,” says Madara.
AMA also asserts the importance of focusing on what’s next on the healthcare horizon. “Let’s just get to ICD-11 and get it done properly,” says Steven Stack, AMA President Elect, in an interview with Healthcare Finance. “We believe the problems associated with ICD-10 are so substantial, our policy is we should not move forward with ICD-10,” Stack adds.
As reported by EHRIntelligence.com, AMA has long been vocal regarding ICD-10's expensive costs for healthcare providers. AMA stated earlier concerns about high ICD-10 implementation costs burdening physicians, draining vital resources required to invest in innovative care delivery models, and hindering the promotion of care coordination. Redirecting needed attention elsewhere will only disrupt the advancement and development of the healthcare industry at large, AMA confirms. Lowering costs while improving the quality of care administered is an ongoing challenge. Nonetheless, protecting revenue stream is a primary aspect of ICD-10 preparation, as RevCycleIntelligence.com reported.
According to a recent Qualitest study, 67 percent of healthcare executives believe an October 1, 2015 ICD-10 implementation deadline will change their hospital revenue. Twenty-eight percent of executives confirm their hospital conducted ICD-10 revenue impact testing with payers. And, 83 percent confirm they think ICD-10 will indeed “go live” on October 1.
