Medicare Refuses to Budge on ICD-10 Deadline

CMS indicated in a statement in January that it would not bend on either the deadline, which had already been postponed once, or on the decision to move to ICD-10.  In a letter to the AMA Feb. 6, Acting CMS Administrator Marilyn Tavenner wrote that implementing ICD-10 to be the new standard for Medicare billing was necessary to modernize the healthcare system, the AMA’s American Medical News reported today.

“Many in the health industry are under way with the necessary system changes to transition from ICD-9 to ICD-10,” Tavenner wrote. “Halting this progress midstream would be costly, burdensome, and would eliminate the impending benefits of these investments.”

Back in November the AMA House of Delegates voted to lobby CMS to abandon conversion to ICD-10, and instead implement ICD-11 in 2017. The AMA managed to persuade dozens of sister organizations to join its protest against moving to the new set of codes.

Cost to providers is the major reason for abandoning the switch, the AMA has maintained. MGMA-ACMPE, the medical practice management association, has projected that adopting ICD-10 would cost a 10-physician practice $285,000; and for smaller practices is about $83,000, the American Medical News reported. The AMA has also maintained that the transition to ICD-10 will conflict with ongoing efforts by the federal government to have providers modernize to electronic medical record systems.

CMS believes exactly the opposite, that ICD-10 will support such modernization. “Integrated programs such as version 5010, the ICD-10 code-set itself, the Medicare and Medicaid electronic health record incentive programs and the physician quality reporting system are all aimed at accomplishing these outcomes,” Tavenner wrote. “Together, they move America’s health care system towards better coordinated care through greater interoperability and ease of transmitting electronic data; better quality measurement and reporting of clinical outcomes data; and lower costs achieved through operational efficiencies.”

The AMA has pledged to continue its lobbying efforts against ICD-10 conversion in Congress, AMA CEO James L. Madara told American Medical News.