TMA Asks Feds to Avert ICD-10 Calamity

Describing the Oct. 1 mandatory transition to ICD-10 as a "potential calamity," Texas Medical Association President Austin King, MD, asked the Centers for Medicare & Medicaid Services (CMS) to consider some moves that would make the transition less risky for physicians and patients. 

Because many physician practices simply aren't ready for it, Dr. King said, the transition could spell disaster and would "disrupt hundreds of thousands of physician practices across the country and threaten the patients who depend on us for care." A recent poll showed just 21 percent of physician practices surveyed say they're on track to be ready Oct. 1.

CMS has completed three rounds of end-to-end ICD-10 testing and reported acceptance rates of 89 percent (March 2014), 76 percent (November 2014), and 81 percent (February 2015). And while the results show most rejected claims were not ICD-10 related errors but errors submitters made, Dr. King said in his March 11 letter, they still indicate serious problems.

"It is reasonable to assume that all of those participating in the testing believed they were prepared for the ICD-10 transition," Dr. King said, "And at least some of those test claims that were accepted likely would have been rejected further down the line for errors unrelated to the acceptance process."

Dr. King expressed particular concern for the readiness of small practices, such as the 63 percent of Texas physicians who are solo practitioners or who practice in groups of three or fewer. In his letter, he outlined three specific requests for CMS consideration:  

  1. Permit a concurrent transition, allowing for the use of either ICD-9 or ICD-10 for a period of two years following the Oct. 1, 2015, implementation date;
  2. Provide a safe haven period during this two-year transition during which physicians will not be penalized for the errors, mistakes, and/or malfunctions that are certain to occur during that transition period; and
  3. Require all electronic health record, practice management, and billing companies to complete all software upgrades no less than three months in advance of the Oct. 1 transition date. Current rules only require that the upgrades be ready by that date. It is imperative that properly functioning software be installed in physician offices with sufficient time to allow proper testing and subsequent adjustments.   

For more practice help on ICD-10, visit TMA's ICD-10 Resource Center

Action, March 16, 2015

Last Updated On

June 13, 2016