Battle Erupts Over ICD-10

“Everybody wants to get into the act,” was a classic line Jimmy Durante muttered when another comedian joined him on stage.

After the AMA’s surprise announcement that it will fight implementation of the coming ICD-10 standards, a number of organizations and individuals right, left and center have weighed in.

For example, a Forbes magazine reporter applauded the AMA action, writing:

“The Administration, between the stimulus bill and Obama Care, has jammed a number of ‘reforms’ down doctors’ throats with nary a gag. Since 2009 doctors have been told that they can’t own their own hospitals, they must use expensive and often buggy electronic health records, they have to work for 29.5% less, and they must kiss the rings of local hospitals and HMOs to form dubious partnerships called ACOs. Soon they will have to seek approval for treatments from an unelected 12-member panel of experts in rationing care.”

One key group to oppose the AMA (and support the current deadline) is AHIMA, where a top executive noted that administrative systems can be easily implemented for most primary care practices and specialty practices would only be using a small number of ICD-10 codes

Where do HIT vendors stand on this? If they sell to hospitals, they probably support the current October 2013 deadline because they have sold many of their customers on an implementation program. If they are one of the many small EHR vendors that sell to physician practices, they may be hoping for delay to avoid the cost of implementation.

Why are the physicians of the AMA (who are generally from smaller practices) so strongly opposed to the ICD-10 mandate?

Start with the fact that almost half of physician practices with five or fewer docs have yet to adopt an EHR. For various reasons, they just don’t want to go digital.

According to the AMA, its main concern is cost. AMA President Peter W. Carmel, MD, said the cost of ICD-10 implementation would be about $28,000 per physician and that a 10-physician practice would spend about $285,195 to make the coding change.

At Modern Healthcare’s HITS newsletter, Joe Goedert published excerpts from a number of letters pro and con.

One skeptic wrote “It is interesting that the shift to the new ICD-10 coding scheme is facing opposition from the AMA. The new system of coding offers increased specificity and granularity, thereby providing better diagnostics and targeted treatment of illnesses.”

Another opined, “The ICD-10 codes are free to everyone, unlike the AMA copyrighted CPT codes which continue to be mandated.”

The AMA is powerful, but not nearly as important as it used to be. Its membership has declined in the last decade and a number of other power centers, notably hospitals, health insurers and pharmaceutical companies have emerged.


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