Saturday, May 18, 2013

AMA acknowledges problems with skipping ICD-10

AMA acknowledges problems with skipping ICD-10

The American Medical Association (AMA) may not push for CMS to move directly to ICD-11 without implementing ICD-10 after all, according to a report of the AMA’s Board of Trustees. The report will be submitted to the House of Delegates during its June meeting and until approved by the delegates, it does not represent the AMA’s official position.

CadusiusAMA members discussed potentially advocating for ICD-11 over ICD-10 during the AMA’s 2012 annual meeting. During that meeting, the AMA House of Delegates adopted Policy D-70.952 “Stop the Implementation of ICD-10.” The policy called for investigating the benefits of moving from ICD-9 to ICD-11.
It turns out that skipping ICD-10 may not be a good thing. The report to the board lists only three reasons to move directly to ICD-11:
  • ICD-11 implementation would be costly and time-consuming regardless of whether the US implements ICD-10
  • Physicians would only have to go through one transition, not two
  • By waiting for ICD-11, healthcare organizations will have more time to adopt electronic medical records develop the electronic systems infrastructure for health information exchange
The AMA report lists six reasons not to wait for ICD-11 including:
  • ICD-9 is outdated and limited (thanks for finally noticing)
  • Healthcare will miss out on the improvements associated with ICD-10 coding, such as laterality, greater specificity, and more room to add codes
  • Healthcare providers and coders will have a more difficult time learning ICD-11 without learning ICD-10 first
  • Focusing solely on moving from ICD-9 to ICD-11 risks missing the opportunity to educate physicians and leaving them unprepared for the anticipated transition to ICD-10, which could result in significant cash flow disruptions
  • ICD-10 should reduce payers’ requests for additional information, which eases the burden on physicians
  • ICD-11 is still 20 years away from implementation (the World Health Organization is still working on the codes and ICD-11 won’t even be beta tested for another two or three years)
That does not mean that the AMA now endorses ICD-10 implementation. It doesn’t.  The AMA touts its success in holding off ICD-10 implementation for more than a decade and for convincing HHS to push the date back from October 1, 2013, to October 1, 2014.
The AMA “harbors serious concerns and reservations” about the burden of ICD-10 implementation and based on current information, doesn’t not recommend moving from ICD-9 straight to ICD-11.
I think it’s great that the AMA is finally acknowledging some of the benefits of ICD-10, but I wish the AMA would actually endorse the switch. Change is never easy, but we’ve put this off long enough.
ICD-10 itself is getting a little long in the tooth. The World Health Organization released the first version of ICD-10 in 1998. Twenty-five countries already use ICD-10, although most don’t use it for reimbursement purposes like the US will.
The benefits to implementing ICD-10 outweigh the disadvantages and frankly, we can’t keep using ICD-9.
Healthcare organizations on both the provider and payer sides have already spent considerable time and money preparing for the transition. Better technology and better patient information are good things. I just wish the AMA would see it that way.

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