AMA Executive Calls for House Speaker Boehner To Block ICD-10 Rollout

Last week, James Madara -- executive vice president and CEO of the American Medical Association -- sent a letter to House Speaker John Boehner (R-Ohio) asking him to stop the federally mandated implementation of the ICD-10 coding system, Modern Healthcare reports (Conn, Modern Healthcare, 1/26).

Background

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch from ICD-9 to ICD-10 code sets means that health care providers and insurers will have to change out about 14,000 codes for about 69,000 codes.

Health care providers and insurers have until Oct. 1, 2013, to adopt new ICD-10 code sets (iHealthBeat, 1/24).

Echoing AMA Resolution

Madara's letter is similar to a resolution that AMA's House of Delegates passed in November 2011 (Modern Healthcare, 1/26).

As part of the resolution, AMA delegates voted to "work vigorously" to stop ICD-10 implementation, saying the health care industry already is overburdened by federal requirements under the health reform law and the meaningful use program (iHealthBeat, 11/15/11).

Madara's Letter

In his letter, Madara argues that ICD-10 implementation "will create significant burdens on the practice of medicine with no direct benefit to individual patient care, and will compete with other costly transitions associated with the quality and health IT reporting program."

Madara noted that health care providers already are facing challenges complying with three federal health IT programs:

  • The meaningful use program;
  • The electronic prescribing program; and
  • The physician quality reporting system.

He asked Boehner to re-evaluate the timelines and penalties for the three programs, adding, "Physicians are being required to meet separate, distinct requirements under these three overlapping programs and have been and will be unfairly penalized if they decide to participate in one program over the other" (Modern Healthcare, 1/26).

Kate Ackerman
Several comments on this thread were deleted because they did not contain the posters' full first and last names. -- The Editors
Norah Polak
It is not the total number of codes that costs providers time, it the the specificity. As you wade through the different types of sinusitis that or possible types of ankle spain, it takes time and concentration away from efforts that actually improve patient care and outcomes.
Norah Polak
I would agree with Dr. Sobrado. Ms. Kohn is demonstrating a stunning lack of knowledge for how these codes are used in reality. Her reference to now having to specify left or right eye demonstrates the absurdity of the situation. WHO CARES WHICH EYE? Will the public policy made for left eyes be different than for right eye? Will a left ey pay more than a right eye? Ms. Kohn fails to understand the added burden on each case. The 20 patients Dr. Sobrado sees daily might have as many as 4-5 ICD codes each and this presents tedious task and a fools errand for the physician on a daily basis as it stands now. Does she think we are all so rich that we can just hire full time coders? In my office and I suspect most offices, the physician selects the code. True, hospitals can afford full time coders and because of DRGs they get more money for more detail, but the individual physician just pulls out his hair when confronted with this new level of stupidity.
Alberto Sobrado
These comments are typical of a bureaucratic mind: "Change" -not the number of codes-is the biggest provider obstacle in making an "efficient" transition to I-10". I would invite anyone including Mrs. Kohn to be in the shoes of a primary care doctor dealing with 15-20 patients every day plus all the burden of these issues. Do you know that now there is a great new industry trying to “catch” doctors miscoding? So these companies of “professional’s coders” can make up to 15% of the monies recoup by insurance companies.
Deborah Kohn
A high number of new codes occurs when a new axis of the classification is added to a broad area of the system. For example, eye diagnoses now have separate codes that specify the affected eye — whether left, right, bilateral, or unspecified. The total number of I-10 codes does not change the basic coding and documentation tasks currently required by providers. Providers' jobs are to document each patient encounter to satisfy the language requirements for complete coding and to get reimbursed. Coders’ jobs are to select the code or codes that will best summarize the total picture of the patient’s health within the constraints of the classification system. Change - not the number of codes - is the biggest provider obstacle in making an efficient transition to I-10.

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