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AMA Backs Bill to Prohibit ICD-10

May 19, 2015
by Rajiv Leventhal
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The American Medical Association (AMA) is supporting the Cutting Costly Codes Act of 2015, H.R. 2126, a proposed bill that would prohibit the Department of Health and Human Services (HHS) from replacing ICD-9 with ICD-10.

Last month, Rep. Ted Poe (R-TX) introduced the legislation into the U.S. House of Representatives, which has since been referred to the Committee on Energy and Commerce and the Committee on Ways and Means. The bill would also require the Government Accountability Office (GAO), in consultation with stakeholders, to conduct a study on ways to mitigate the disruption on healthcare providers resulting from a replacement of ICD-9 with ICD-10.The current deadline for ICD-10 implementation is Oct. 1, 2015.

According to a May 14 letter from AMA vice president James Madara, M.D., written to Poe, “The differences between ICD-9 and ICD-10 are substantial, and physicians are overwhelmed with the prospect of the tremendous administrative and financial burdens of transitioning to ICD-10.” Madara writes, “Implementation will not only affect physician claims submission; it will impact most business processes within a physician’s practice, including verifying patient eligibility, obtaining pre-authorization for services, documentation of the patient’s visit, research activities, public health reporting, and quality reporting.  This will require education, software, coder training, and testing with payers.  As HIPAA-covered entities, physicians will be responsible for complying with this ICD-10 mandate, and therefore will bear the entire cost of such a transition.  Furthermore, not only will physicians face the prospect of significant disruption in claims processing and payment during the transition to ICD-10, any physicians who are unable to transition to ICD-10 by the implementation date simply will not get paid.”

AMA President Robert Wah, M.D., has been outwardly critical about ICD-10 before. In an address to AMA's House of Delegates in November, Dr. Wah characterized the planned implementation of ICD-10 as analogous to the dark forces controlling the galaxy in the movie “Star Wars.” He said in the speech, “Each of the six ‘Star Wars’ films has this line: ‘I have a bad feeling about this.’ That’s a common reaction to ICD-10.  If it was a droid ICD-10 would serve Darth Vader.”

In this letter to Poe, Madara added that, “The timing of the ICD-10 transition could not be worse as many physicians are currently spending significant time and resources implementing electronic health records (EHRs) into their practices and adopting new payment and delivery models.”

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