ICD-10: Headache for Doctors; Heartache for Patients

*Below is the letter Medical Association and President Ronald Franks sent to Alabama’s Congressional Delegation urging support to delaying implementation of ICD-10 until October 2017..

Jan. 7, 2015

Dear Alabama Congressional Delegation;

On behalf of the Medical Association of the State of Alabama and our more than 7,000 physician members, we urge you to support delaying implementation of the new medical coding system known as ICD-10 until October 2017.

Forced adoption of this new coding system, which is scheduled for Oct. 1, 2015, will require everyone in a medical practice who touches a patient’s chart – from the physician to the person submitting the claim to the insurance company – to learn four times as many new medical codes as the current system, ICD-9. While the 16,000 medical codes in ICD-9 are well-known, ICD-10 contains more than 68,000 diagnostic codes. There are more than 250 codes for diabetes alone, and with four times as many codes as ICD-9, the government and insurance companies will have four times as many reasons to use ICD-10 coding mistakes to deny medical care!

While spending more time with patients is what patients and physicians want, under ICD-10 we will instead spend more hours in front of a computer screen scanning 68,000 medical codes looking for the right one. Not only will ICD-10 have no direct medical benefit for patients, this mandate is also a tremendous financial burden for medical practices already operating on shoestring budgets. The U.S. is the only country implementing all 68,000 new codes and the only country tying a massive coding system to a complex billing system. Further, experts from the Centers for Medicare & Medicaid Services warn physicians may not get paid for three to six months due to ICD-10’s extensive and complicated implementation. With the likely improbably the system works properly by Oct. 1, 2015, medical practices can’t absorb such long delays in payment.

The transition to ICD-10 is expected to cost more than $1.64 billion over 15 years, with more than 40 percent of that expense coming from the cost of upgrading information technology systems for different participants including the government, insurance companies, physicians and hospitals. While many hospitals are in favor of ICD-10 implementation this year, the people treating patients and responsible for navigating all 68,000 codes – physicians – stand firmly against implementation and in favor of a two-year delay. Physicians will be hardest hit by ICD-10 since the massive cost of software and training is not as easy to spread over a small medical group as it is over an entire insurance company, hospital system or government agency.

Forced adoption of ICD-10 has very real consequences for physicians and the timing could not be worse, when financial strain on medical practices is at its highest point in history. As physicians struggle to implement costly electronic health records and meet stringent quality measures under Medicare’s Physician Quality Reporting System, at the same time we never know when Congress might allow the flawed Medicare SGR formula, or “doc fix,” to expire, further cutting already inadequate Medicare payments by 20 to 30 percent. While our patients want better care and society demands innovation, physicians are drowning under a tsunami of government regulations, and adopting ICD-10 this year will only add to the problem.

Please don’t force this on medical practices this year. Instead, help us by stopping mandates like ICD-10 that stretch our resources and limit the time we spend with our patients. With ICD-11 coming in the near future, we ask your support for a delay of ICD-10 at least another two years so we can change how it will be implemented to protect physicians and patients. We may find that skipping ICD-10 entirely and moving to ICD-11, which is more compatible with electronic medical records, makes more sense. Please tell Speaker Boehner, Chairman Fred Upton and Chairman Pete Sessions that delaying ICD-10 for two years is a priority.

Thank you for your consideration.

Dr. Ronald Franks
President, Medical Association of the State of Alabama

Cc: U.S. Sen. Jeff Sessions
U.S. Sen. Richard Shelby
U.S. Rep. Robert Aderholt
U.S. Rep. Mo Brooks
U.S. Rep. Bradley Byrne
U.S. Rep. Gary Palmer
U.S. Rep. Martha Roby
U.S. Rep. Mike Rogers
U.S. Rep. Terri Sewell

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