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ICD-10: The Final Countdown

February 13, 2014
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In less than eight months, the U.S. healthcare industry is slated to change forever when providers are required to make the transition to the 10th revision of the International Classification of Diseases code-set. 

Yes, the day of ICD-10 is almost upon us. 

Of course, the key word there is "slated." In high school, I was "slated" to dance with the prettiest girl in my grade--you know, in my head. The Patriots are "slated" to win the Super Bowl every year before the season starts--also in my head.

Sometimes things don't work out the way we imagine and in that sense, eight months is a long time. A lot can change in eight months. No one knows this more than the American Medical Association (AMA), which this week picked back up its longstanding battle against the ICD-10 transition.

In a letter sent to Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services (HHS), the AMA laid out the reasons why the ICD-10 mandate should be reconsidered. For one, AMA says the ICD-10 transition is "financially disastrous" for physicians. It cites a report from the Nachimson Advisors, that says the estimated price for a small practice to meet ICD-10 requirements will range from $56,639 to $226,105. This is considerably more than original estimates, AMA argues.

Tied into that financial argument is the AMA's claim that the ICD-10 "impedes the progress to a performance-based environment." I'll let James Madara, M.D., the executive vice president and CEO, who wrote the letter, explain:

Continuing to force physicians down the ICD-10 path will result in significant financial burdens for physicians. This impact will be compounded by their inability to devote time and resources to meeting other federal mandates that carry hefty financial penalties, which further threaten their financial viability.

The organization then ties this into the idea of readiness. According to the AMA, fewer than half (47 percent) of physicians queried say their practice management system (PMS) vendor plans on delivering them an ICD-10 software upgrade. Of those who will get an upgrade, most are not sure when it will even happen. 

The AMA also expresses concern over the lack of required end-to-end testing for ICD-10 and an inflexible advanced payment policy that it says could inevitably disrupt cash flow for physicians. The letter is pretty thorough and is probably worth a read.

But wait there's more. Apparently, the AMA has taken the cause to Twitter. They have started a #StopICD10 hashtag. Although to date, it hasn't taken off quite yet but I imagine it'll be trending worldwide before you know it.  

The AMA is not alone in its pursuit of this cause. The Medical Group Management Association (MGMA) also recently released data that argues the industry is too far behind in compliance. I've seen quite a few additional surveys, research efforts, and the like, that all basically come to the same conclusion. 

But what will happen? The compliance date has been delayed before, and obviously, AMA and other stakeholders are banking on that happening again. However, when I talked to leading CIOs last year for a feature I wrote, many like John Halamka, M.D., CIO of Beth Israel Deaconess Hospital in Boston, said another delay didn't seem likely at this point. Texas Health Resources, senior vice president and CIO, Ed Marx said he was moving forward as if a delay wasn't going to happen. 

It's not impossible, but it does seem unlikely. The Centers for Medicare and Medicaid Services (CMS) itself went on record to say there would be no more delays. 

From EHR Intelligence: "“There will be no more delays. Those who are postponing ICD-10 implementation planning, thinking there might be additional delays, should really begin to plan implementation now.  There will be no more delays to the ICD-10 implementation date," Pat Brooks, senior technical advisor at CMS. 

That's a pretty strong statement. He even said it twice. Of course, as I said, things don't always happen like we envision. Stay tuned folks!

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