Docs, payors say ICD-10 timetable is recipe for disaster

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ICD-10 transition needs pilot testing, more time to be successful. Image Source:  

While the ICD-10 code set has the potential to transform the healthcare system, the three-year timeframe proposed by the Department of Health and Human Services (HHS) is not long enough to make a successful transition, according to physicians and health insurers.

Representatives of the Medical Group Management Association (MGMA), the American Medical Association (AMA) and America’s Health Insurance Plans (AHIP) have taken issue with the proposed schedule for converting to a new system for coding diagnoses and treatments.

“The adoption of ICD-10 is long overdue, and the replacement to ICD-9 [Clinical Modification] has been discussed over the past 10 years,” said Rick Pollack, the executive vice president of the American Hospital Association, according to Government Health IT.

HHS proposed a deadline of April 1, 2010 for the transition to Version 5010 of the X12 transaction standard; however, MGMA and AHIP are advocating a two-year timeframe and another three years for the changeover to ICD-10 billing and diagnosis codes. HHS’ proposed rule would set a deadline of Oct. 1, 2011 for ICD-10.

When MGMA surveyed medical practices, 95 percent of respondents said the transition would require them to upgrade or replace their practice management software. Nearly two-thirds expected to have to buy code-selection software.

The 30-year-old ICD-9 has about 17,000 codes for diagnoses and treatments, while the newer ICD-10 has more than 155,000 codes. While the representatives support the transition, they are opposed to the short timeframe in which to complete the transition.

“CMS should have instituted pilot testing in a broad array of clinical settings before publishing the rule to fully ascertain the impact of ICD-10 on the healthcare system. It is a recipe for disaster to force such a change without pilot testing and allowing sufficient time for implementation,” said William Jessee, MD, president and CEO of MGMA.