An AMA study released last week estimated dramatically high costs for practices to implement the mandated ICD-10 code set. As a physician, the study results were very frightening.
Costs to implement ICD-10 could be nearly three times as much as the already substantial costs estimated in earlier studies. Small physician practices could be looking at more than $225,000, while large practices could spend up to $8 million. The average practice just doesn’t have the kind of money required to effectively and efficiently implement this code set.
The AMA has been able to keep ICD-10 at bay for more than a decade, but the current deadline of Oct. 1 has stood firm since we secured a yearlong delay in February 2012. And so we have continued our efforts to stop implementation.
In tandem with releasing our study last week, we sent a letter to U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius, urging her to intervene on physicians’ behalf.
Setting aside the prohibitive cost issue, ICD-10 implementation poses a significant threat for physicians to keep their practices running. Many physicians aren’t expecting to receive their software upgrades until later this year, and there aren’t any plans for comprehensive testing.
At the insistence of the AMA, the Centers for Medicare & Medicaid Services (CMS) agreed to do a testing week March 3-7, during which time help desk support will be available. But this testing is very limited. It isn’t end-to-end, so it won’t tell us whether physicians and the industry really are prepared.
We’ll be able to learn whether a Medicare contractor received a claim and whether it was accepted or rejected, which is a start. But other essential factors won’t be touched, including whether a claim has been paid, how much will be paid and whether the correct code was used. It’s far too short, and far too short-sighted.
We know from other countries’ implementation of ICD-10 that physician productivity will take a real hit. An impact analysis of Canada’s transition, for instance, revealed a high risk for claims processing and payment disruptions. Some Canadian health care professionals have said they were never able to return to their productivity prior to implementation a decade ago. With nearly 70,000 codes compared to the 17,000 codes of the Canadian ICD-10 version, we could see more significant problems.
The study published by the AMA on the latest cost estimates for physicians to move to ICD-10 underscores what we’ve been saying all along: Implementing ICD-10 at the same time we’re being required to adopt new technology, re-engineer workflows and reform the way we deliver care will have financially disastrous consequences. More importantly, it will interfere with our ability to care for patients.
The AMA will continue to put pressure on HHS to reconsider implementation of the new code set—the financial and operational implications for physician practices are too great to overlook. You can ask your members of Congress to co-sponsor legislation to stop ICD-10 implementation, known as the Cutting Costly Codes Act of 2013, by sending an email through the AMA’s Physician Grassroots Network. You also can voice your support to #StopICD10 on Facebook and Twitter.
