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AMA Wants Protection for Doctors Rolling Out New ICD-10 Coding System

Physicians shouldn’t be penalized for errors, mistakes, or system malfunctions, group says

During its annual meeting, the American Medical Association (AMA) has attempted to mitigate the potential problems that could result from implementation of the new ICD-10 medical coding system by calling for a 2-year grace period, during which physicians will not be penalized for errors, mistakes, and/or malfunctions of the system.

“The bottom line is that ICD-10 will significantly overwhelm physician practices with a 400% increase in the number of codes physicians must use for diagnosis, which will take time away from the valuable one-on-one patient–physician interface that is the hallmark of taking the best care of patients,” said AMA board member Russell W.H. Kridel, MD. “We continue to press both Congress and the administration to take necessary steps to avoid widespread disruption to physician practices created by this overly complex and burdensome mandate. Coding and billing protocols should never get in the way of patients receiving high- quality care.”

The AMA has long been an advocate for reducing the “tsunami” of regulatory burdens on physician practices so that they can focus their energy on what’s important: patient care. Efforts to diminish the negative impact of ICD-10 also include advocating for the U.S. Department of Health and Human Services to create hardship exemptions for physicians whose billing software or claims processing clearinghouses are unable to make a smooth transition.

ICD-10, which is designed to better track diagnoses and treatments, affects dozens of core applications for health care providers and insurance payers. Currently, there’s an October 1, 2015 deadline for implementing the new medical coding system.

While the AMA has voted in favor of delays, conversely, health-care chief information officers (CIOs) and other information technology leaders have expressed concerns about deadlines being extended, according to an article posted on the Computerworld web site.

ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems, a medical coding system developed and used by the World Health Organization. The new system replaces approximately 15,000 codes used in ICD-9 with approximately 68,000 new ones.

The new codes are much more descriptive, Computerworld says. For example, if a physician is treating a broken ankle, an ICD-10 code needs to be selected for which leg the ankle is on; whether the injury is on the lateral or medial side; and whether the injury is an open or closed fracture. At times, the detail with which ICD-10 codes describe medical conditions borders on the bizarre. For example, if a person were stabbed while crocheting, his or her doctor would use the code Y93D1. Sucked into a jet engine? That’s V97.33XD. There’s even a code for having been attacked by a squirrel!

The new coding system is so complex that the federal mandate requiring it has been delayed twice, Computerworld says. As its current deadline approaches, there are industry rumblings that it may be delayed again.

Sources: AMA; June 9, 2015; and Computerworld; June 9, 2015.

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