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ICD-10 Cost, Timing Concerns Explain AMA Vote

Cheryl Clark, for HealthLeaders Media, November 17, 2011

Bowman added that those concerned about moving from the antiquated coding system, "have had an extensive public debate about ICD-10 over the last 10-15 years, and the federal government has come out with a final regulation to move forward."  The government was responsive to those concerns, even delaying implementation by several years.

Lastly, she argues, "It's important to remember that as time marches on, ICD-10 doesn't get any easier or cheaper to implement."

"With meaningful use, electronic health records, value-based purchasing and payment reform, frankly, a lot of us wish we already had ICD-10 in place. If we did, we could be taking advantage of better data today."

The AMA delegates, however, are steadfast. In their resolution they make the following points:

  • Physicians are already under much stress both from increased paperwork and increased financial obligations of the Patient Protection and Affordable Care Act and electronic medical record requirements
  • If ICD-10 is enforced to the letter of the law, physicians will need certified coders to read the physician's notes and add the diagnosis codes in order to prevent payers from denying payment."
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6 comments on "ICD-10 Cost, Timing Concerns Explain AMA Vote"


RMartinez (2/12/2012 at 9:01 AM)
There are more facts to this than stated by those against the conversion. ICD-10 came out in 1993 and the US has been using ICD-10 mortality codes since around 1999. The current ICD-9 reflects our knowledge from the 1970's, when ICD-9 came out. Our ability as physicians to improve care is based on the quality of the data we have, so there is very good reason to install a more accurate system. Part of the push back and concern is that people are just now focusing on this and have concerns about cost. Understandable, but lets figure out how to improve the system and our practice for our patients. We are pretty good about getting things done when we put our shoulders together.

Diane Bristol (11/18/2011 at 11:35 AM)
Ms. Clark, I read your November 17, 2011, article on ICD-10 and it is clear that you're not in the trenches in a physician office. The estimated cost of implementation as well as lost productivity by the physician will lead to another access problem for patients. Learning an entirely new coding system and then finding the right code will be a costly, time-consuming project for both physicians and the billers/coders. I discussed ICD-10 implementation with my Congressman last spring. He indicated that Congress was led to believe that the USA was the last country in the world to adopt ICD-10. I provided him with MGMA information that no other country is using ICD-10 in the physician offices (with the exception of Germany) and other countries are only using a limited version of ICD-10 in their hospitals. For instance, MGMA provided information that Canada is using only 17,000 codes and Australia only 22,000 codes – and again, only in hospitals...not in physician practices. Canada and Australia took several years implementing ICD-10 one province/state at a time, and the governments of Canada and Australia paid for all expenses related to implementation. The cost of implementation of ICD-10 is estimated to be near $84,000 for my 3-physician office. Not only do we not have money available for this project, we have absolutely no way to recoup it if we borrowed it. Most patients are under some type of contracted payment – Medicare, Medicaid, BCBS, Managed Care plans, etc. Therefore, no matter what we charge for services, we only receive what the insurance company allows......the rest we write off. It amazes me that every other business in the country is allowed to increase their fees to recover increased costs except the field of medicine. ICD-10, in my opinion, is another unfunded mandate required by CMS with no real benefit to the patient. Diane Bristol MGMA member - Michigan

Steve Levine (11/17/2011 at 2:22 PM)
You left three key medical societies out of your list. We submitted a separate resolution that was also rolled into the one that passed. Please add the Texas, Nebraska, and North Carolina AMA delegations to your story. Thanks