AMA, AHIMA diverge on ICD-10 views

While the American Medical Association (AMA) is calling for a halt to ICD-10, the American Health Information Management Association (AHIMA) is countering by urging all to stay the course toward the Oct. 1, 2013 deadline.

In a letter sent Thursday to Department of Health and Humans Services Secretary Kathleen Sebelius., AMA CEO James Madara, MD urged HHS “to make good on its commitment to improve the regulatory climate for physicians.”

“On behalf of the physician and medical student members of the AMA, I am writing to urge you to immediately halt the Health Insurance Portability and Accountability Act (HIPAA) required implementation of ICD-10, and re-evaluate the penalty program timelines associated with the number of Medicare health IT programs underway today,” Madara wrote.

Congress has passed multiple health IT programs under separate laws affecting physician practices and provided HHS with the discretionary authority to come up with appropriate reporting requirements for these separate federal health IT programs, AMA went on to say.

However, AHIMA  argues for staying the course on ICD-10.

“If healthcare providers stop their ICD-10 planning and implementation now and wait to see if Congress will take action, they will not be ready in time for the compliance date,” said Dan Rode, AHIMA vice president for advocacy and policy.

“The move to ICD-10-CM/PCS is at the foundation of healthcare information changes underway in the United States,” Rode said. “Without ICD-10 data, there will be serious gaps in our ability to extract important patient health information that will give physicians and the healthcare industry measures for quality of care, provide important public health surveillance, support modern-day research, and move to a payment system based on quality and outcomes.”

Implementing ICD-10 is not just a technology project, according to Madara. It will impact most business processes within a physician’s practice, including verifying eligibility, obtaining pre-authorization for services, documentation of the patient’s visit, research activities, public health reporting, quality reporting, and, most of all, submitting claims. Implementing ICD-10 requires physicians and their office staff to contend with 68,000 diagnosis codes – a five-fold increase from the current approximately 13,000 diagnosis codes, according to AMA.

“The concern that physicians must use all the codes in the ICD-10-CM system is inaccurate. Like we use dictionaries to find specific words, practitioners use those codes that best fit their practice,” Rode said.

He also said AHIMA coders have shown that a “super bill” – a form that many practices still use – can be assembled in less than a day for most small practices, making the transition easy for those who do not want to invest in other automated options.

The AMA counters that  depending on the size of a medical practice, the total cost of implementing ICD-10 ranges from $83,290 to more than $2.7 million.

Follow Diana Manos on Twitter @DManos_IT_News.

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