Opposition to ICD-10 timetable emerges

By Nancy zz_Ferris
06:15 PM

Doctors and health insurers are taking issue with the government's proposed schedule for converting to a new system for coding diagnoses and treatments.

Representatives of the Medical Group Management Association (MGMA), the American Medical Association and America's Health Insurance Plans (AHIP) said today that the three-year transition the Health and Human Services Department has proposed for transitioning from International Classification of Diseases Version 9 to ICD-10 is not long enough.

However, the American Hospital Association joined the American Health Information Management Association and other organizations in support of the proposed rule, which was announced Aug. 18.

"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, AHA's executive vice president, in a statement.

However, Dr. William Jessee, president and chief executive officer of MGMA, said moving to the new code set "has the potential to be the most complex change for the U.S. health care system in decades."

In addition, MGMA and AHIP are advocating a two-year transition to Version 5010 of the X12 transaction standard - a few months more than HHS would allow. HHS has proposed a deadline of April 1, 2010.

Officials at the two organizations said HHS should allow another three years for the changeover to ICD-10 billing and diagnosis codes. HHS' proposed rule would set a deadline of Oct. 1, 2011.

AHIP and MGMA said their organizations support making the transition to ICD-10 and merely object to the proposed schedule.

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.

"As we have seen with the protracted implementation of other requirements of [the Health Insurance Portability and Accountability Act], such massive system and workflow changes necessitate coordinated actions among medical groups and their vendors, clearinghouses and health plans," Jessee said in a statement. "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 health care system. It is a recipe for disaster to force such a change without pilot testing and allowing sufficient time for implementation."

An AMA spokeswoman said her organization would issue a statement soon about its concerns.