With less than four months to go before the deadline for implementing the ICD-10 code set, physicians Monday agreed to seek a two-year grace period for physicians to avoid financial disruptions to facilitate a smoother transition that would allow physicians to continue providing quality care to their patients.
Physicians at the 2015 AMA Annual Meeting passed policy calling on the Centers for Medicare & Medicaid Services (CMS) not to withhold claim payments based on coding errors, mistakes or malfunctions in the system for two years directly following implementation.
Related policy pushes the AMA to advocate for physician voices to be part of the group that manages the International Classification of Diseases (ICD). Currently, the four cooperating parties that manage ICD code sets are the Centers for Disease Control National Centers for Health Statistics, CMS, the American Hospital Association and the American Health Information Management Association. A physician group is necessary in these conversations because none of the current groups “represent providers who have licensed authority to define, diagnose, describe and document patient conditions and treatments.”
The new policy also directs the AMA to seek data on how ICD-10 implementation has affected patients and changed physician practice patterns, such as physician retirement or moving to all-cash practices.
“The bottom line is that ICD-10 will significantly overwhelm physician practices with a 400 percent increase in the number of codes physicians must use for diagnosis, which will take time away from the valuable one-on-one patient-physician interface that is the hallmark of taking the best care of patients,” said AMA Russell W.H. Kridel, MD, member of the AMA Board of Trustees. “We continue to press both Congress and the administration to take necessary steps to avoid widespread disruption to physician practices created by this overly complex and burdensome mandate. Coding and billing protocols should never get in the way of patients receiving high quality care.”
CMS has acknowledged that the transition to ICD-10 will have an impact on physician payment processes. The agency estimates that “in the early stages of implementation, denial rates will rise by 100-200 percent,” according to a 2013 report from the Healthcare Financial Management Association.
A 2014 AMA study conducted by Nachisom Advisors on the cost of implementing ICD-10 estimated that a small practice could see payment disruptions ranging from $22,579 to $100,349 during the first year of ICD-10 implementation. The study also estimates that a small practice could incur a 5 percent drop in revenue because of productivity loss during and after the change.
While the AMA continues to urge regulators to ease the burden of ICD-10 implementation on physicians, you should act now to make sure your practice is prepared.
Looking for resources? An ICD-10 data file available on CD-ROM or via immediate download is an essential tool. Additional information and resources to help physicians get ready for ICD-10 are available on the AMA ICD-10 Web page.
Check out a series at AMA Wire® that offers timely transition tips and resources, and find out what your practice should do to prepare financially for ICD-10.
