EHR and Meaningful Use Articles > AMA: If ICD-10 is a must, don’t penalize us for doing it wrong

AMA: If ICD-10 is a must, don’t penalize us for doing it wrong

Author | Date June 25, 2013

The American Medical Association’s crusade against ICD-10 continues.  When the AMA’s House of Delegates met last week, it wasn’t just to address public health concerns like obesity and gun control: it was to reaffirm its resistance to the way ICD-10 implementation is being planned and enforced.  In order to avoid the anticipated payment disruptions and productivity losses, the AMA wants a two-year grace period for coding errors, in which payers would be barred from denying claims due to ICD-10 coding errors or a lack of specificity.

In addition to forbidding denials, payers would be required to provide constructive feedback on all ICD-10 errors including incorrect diagnoses and unspecified codes.  While this sounds like good news for providers, the additional burden this will place on payers may just be pushing the financial effects of the transition slightly downstream, not get rid of the problem.  And if the current implementation climate is any indication, providers will simply put off education and documentation improvement as long as humanly possible, causing another scramble to get ready for the AMA’s predicted financial ruination two years from now.

The vote also included a wholesale rejection of a recent internal report that found skipping ICD-10 for ICD-11 is not recommended.  This means that the AMA will continue to lobby CMS to stick with ICD-9 until ICD-11 is available at some unspecified point in the future.   Last week’s resolution stated that the AMA will continue to “assess an appropriate replacement for ICD-9 and evaluate the feasibility of mobbing from ICD-9 to ICD-11 as an alternative to ICD-10,” regardless of the fact that the report they just snubbed was designed to do exactly that, but came up with an answer they didn’t like.

While the AMA has valid concerns about the financial impact of ICD-10, and it’s true that providers are nowhere near ready to tackle the obstacles facing them in the few short months until October 1, 2014, they’re not doing much to help the situation by giving reticent providers hope that there will be a miracle.  Both CMS and the ONC have firmly stated that 2014 will be the date, and the AMA will need to get on board soon if they really want to help providers avoid a disaster.

Physicians always insist that patients take their medicine when it’s prescribed in order to avoid complications down the line.  Why isn’t the AMA investing in a little preventative care for their members instead of pretending that this necessary evil is just going to go away if they ignore it long enough?

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  • Joanne McNamara

    With all due respect, I don’t want a podiatrist to give me a face lift, I don’t want a chef to pull an abscess tooth. WHY is EVERYONE IGNORING THE OBVIOUS….HIRE A QUALIFIED SEASONED CERTIFIED CODER, OR PAY FOR A GOOD EMPLOYEE TO RECEIVE TRAINING IN THIS FIELD OF SUCH GREAT DEMAND! If you employ a Certified Professional Coder, CPC, CPC Specialty, or a coder who’s worked with your documentation for 20 years, how could you not trust him/her to help you through this major transition? A CPC must pass a certification in ICD-10-CM to keep their credential. I’m an advanced Certified coder (physician) CPC, recertified 17 years with CEUs. I started coding in 1975, when hired by a Federal Government Health Care Facility. I have 38 years experience in coding, training in coding, preparing curriculum in coding, coordinating and directing coding projects, I have been published, presented, I am a CPMA, certified Professional Medical Auditor, ICD-10-CM has been used in our Public Health System and will make accessing information for you so much easier, as it does in 60 other leading nations who do not have a financially based health care system. THEE IS NO EXCUSE. THE EXPENSE OF WHAT YOU ARE DOING NOW, DELAYING, IGNORING THE EXPECTS WHO DO THIS COLUMNAR INDEXING OF CATEGORIAL DATA, only they do with a master of medical language. IT ISN’T ALL ABOUT THE MONEY, BUT IF YOU KEEP FIGHTING THE INEVITABLE, YOU ARE WASTING MUCH MONEY FIGHTING the system that has been used by HHS in CDC &P and NIH for years. Other countries have access to our data before our doctors. ICD-10-CM reporting to the CDC will result in an immediate recognition of a possible sudden outbreak, or to provide information immediately., American taxpayers have been paying for the CDC National Center for Health Statistics to maintain both CM for ICD-10 for the Public Records, Emergency Response, etc, and for the sake of private, third party payers, the ICD-9 not published since 1990 up to date. HHS uses both. Getting rid of the antiquated ICD-9 will save money. FEAR OF MISTAKES? Of course there are going to be mistakes, but don’t forget, the TPP will make mistakes too. A CPMA can pick up pre-submission errors with a quick glance. A well trained CPC will know all the “Tricks”, so support CPs and truly save money…..an average salary of $60,000, some continued education, and you’ll have a much better chance of reduction in errors, greater appeals, and much greater patient care. To me, coding is so simple, I understood the official Draft of CM in early 2009, I had been reading the work on ICD-10 since 2000. Coders understood this, they really do. SO, if you want quality coding, hire a CPC coder.

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