AMA Delegates Vote to Stop ICD-10 Implementation
On Tuesday the American Medical Association’s House of Delegates voted to “work vigorously” to stop the implementation of ICD-10-CM/PCS.
“The implementation of ICD-10 will create significant burdens on the practice of medicine with no direct benefit to individual patients’ care,” said Peter W. Carmel, MD, AMA president, in a press release. “At a time when we are working to get the best value possible for our health care dollar, this massive and expensive undertaking will add administrative expense and create unnecessary workflow disruptions. The timing could not be worse as many physicians are working to implement electronic health records into their practices.”
The healthcare industry must upgrade to the new code set on October 1, 2013. The Department of Health and Human Services set the deadline through regulation published in early 2009.
ICD-10 has been a subject of debate for years. The Centers for Disease Control and Prevention and Centers for Medicare and Medicaid Services developed a US version of the international ICD-10 in the late 1990s, but objections from providers and payers reluctant to make the transition held off implementation for 10 years.
AHIMA Expresses ‘Disappointment,’ Disagreement
In a press release, AHIMA indicated its disappointment with the American Medical Association’s House of Delegates vote, saying adoption of a 21st century classification system will bring important benefits to patients, providers, and payers.
“We need to move our disease classification system toward international standards and also align it with the Meaningful Use incentive program as well as value-based reimbursement,” said AHIMA CEO Lynne Thomas Gordon, RHIA, FACHE, in the release.
“The provider reimbursement system is moving to payment for quality care and the use of a more contemporary, detailed coding system that will support quality care, public health, and research both nationally and internationally,” she continued.
AHIMA also stressed that the current ICD-9 classification system—now three decades old—has essentially run out of codes and cannot fully express 21st-century medical knowledge.
“The move to electronic health information and exchange will not benefit the public if we do not also improve the information that these new systems will create and exchange,” said Sue Bowman, RHIA, CCS, AHIMA director of coding policy and compliance.
AHIMA has demonstrated several times that administrative systems can be easily implemented for most primary practices and that specialty practices will use a small number of the codes, Bowman noted.
“The classification system is like a dictionary,” she said. “You only use it for the codes that represent the diseases that your practice encounters, which would not be every code in the book.”
AHIMA has already disagreed with the AMA over its estimated cost of implementation in physician practices.
In its press release, AMA cited a 2008 study by Nachimson Advisors, which forecast that a small three-physician practice would need to spend $83,290 to implement ICD-10, and a 10-physician practice would spend $285,195 to make the coding change.
In a review of the report at the time of its publication, AHIMA found that the forecasts:
- Failed to address how ICD-10 might benefit the practice of medical care and improve the efficiencies and effectiveness of administrative processes in physician practices and laboratories.
- Assumed that in the short course of the proposed implementation (essentially three years), practices would be required to implement every potential change related to using an improved classification system. There is nothing in the federal regulation to indicate use of the additional detail available in ICD-10-CM will be required.
- Ignored the adoption of electronic health records that impact and are impacted by the use of ICD-10-CM.