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.

Differing Assumptions

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.

1 Comment

  1. From reading the article, I do feel it is time to update the ICD-9 CM to a more broader based system of diagnosing. Although I have not had a chance to see how the new ICD-10 would work, if it gravitates to being more detailed for a more specific and accurate diagnois than I believe this should have been done a lot sooner than now and actually this should have been implemented before meaningful use. How can we as medical professionals whether we are the provider the biller or the medical receptionist say that we are complying with meaningful use if we don’t have the proper ICD codes available to diagnosis our patients. One thing I would like to say is that I feel providers should really pay attention to what they are coding on a patients visit. Often times I see that although technology has blessed us with the ability to reduce billing times with the use of PM software but all too often information is used repeatedly from previous visits which result in diagnoses that may no longer apply are still being used because it is being pulled from the system. I would like to see coding done based on actual real time visit. If you have a patient that was diagnosed in the past for a symptom and they have progessed to no longer having that then it should be no longer used. If I am wrong someone please correct me. That is why I feel if the new coding system is more symptom specific and accurate I am all for it, but if a practice is barely thriving and still trying to be compliant then I also believe there should be options so that doctors offices and hospitals are not closing their doors just because they can’t the latest healthcare upgrades. Something has to give, besides if the doors close no one will get any treatment or a diagnosis and that is not the result we all want. Thank you!

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