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The American Medical Association continues to exert power to legislative and executive branches to squash the start date of ICD-10-CM. A recent letter was sent by AMA Executive Vice President and CEO, James Madura, MD seeking out the help of Congress and, more specifically, House Leader John Boehner, in this regard.

At this week’s AMA conference in Washington, DC, the Center for Medicare-Medicaid Services (CMS) acting Administrator Marilyn Tavenner indicated that CMS has agreed to “re-examine” the implementation date of October 1, 2013. Some critics believe that a postponement is inevitable based on provider concerns. AHIMA, however, addressed their membership to move forward with the implementation date and warned hospitals and health care providers not to suspend their ICD-10 planning efforts.

Physicians have been using the financial burden for holding ICD-10-CM and PCS in check. The major disagreement is the expense of their office implementation of the ICD-10-CM diagnostic system into their daily operations while also implementing electronic transaction 5010, quality initiatives, e-Prescribing, and EMR simultaneously. Implementation costs for a typical 10-doctor practice are estimated at $285,000 to convert to ICD-10-CM according to a recent study. The software cost associated with the transition would be approximately $25,000. Additional costs would come from claims queries, training, reductions in cash flow and, most importantly, documentation time.

Although there is significant financial overlay for this new system, the bigger issue, in my opinion, is the additional time physicians must absorb in clinical documentation initiatives not yet seen under ICD-9-CM and demonstrated by increasing the actual diagnostic and procedural codes and their descriptions from 13,000 codes to 68,000 codes. These additional codes will require more physician specificity as the system is designed to capture more granular data to be shared with world health organizations while meeting MS-DRG reimbursement demands for hospital inpatients.

As early as 2008, the AMA, their collective subspecialties, and the state Medical Societies all signed a letter to the Secretary of HHS asking for a 60 month hiatus (5 years) from 5010 electronic transaction implementation to the ICD-10-CM implementation. The letter was clear that the provider community could not financially meet the timelines of all government expectations within a very condensed period of time.

As expected, on Wednesday evening, 2/15/12, Secretary Kathleen Sebelius indicated that there would likely be a postponement of ICD-10. With all the dollars already invested by hospitals and other healthcare institutions anticipating an October 1, 2013 start, what impact will this delay have the future of healthcare data?

Only Time will tell.


AHIMA E-Alert, February 9, 2012, pg 1

AHIMA E-Alert, February 16, 2012, pg 1; ASC Review, January 27, 2012, pg 1

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