100 Physician Groups Petition For ICD-10 Contingencies
By Christine Kern, contributing writer
A seven-page letter sent to CMS calls for addressing concerns about ICD-10 transition.
Together, the American Medical Association (AMA) and 99 state and specialty societies penned a letter to the Centers for Medicare and Medicaid Services (CMS) calling for contingency plans to cover the pending ICD-10 transition, according to a press release.
“By itself, the implementation of ICD-10 is a massive undertaking,” the AMA and fellow signatories write in the seven-page letter to CMS Acting Administrator Andrew Slavitt. “The undersigned organizations remain gravely concerned that many aspects of this undertaking have not been fully assessed and that contingency plans may be inadequate if serious disruptions occur on or after Oct. 1.”
The CMS reported 81 percent of the 15,000 test claims submitted in its end-to-end testing pilot were accepted, and called the results “successful,” according to Health IT Outcomes. According to a CMS report on the week’s activity, 56 percent of test claims were professional, 38 percent were institutional, and 6 percent were supplier. “Testing demonstrated that CMS systems are ready to accept ICD-10 claims,” notes CMS.
According to the AMA, the recently released data on the end-to-end testing pilot done by the CMS demonstrated the claims acceptance rate would drop to 81 percent from 97 percent if ICD-10 were implemented today. The AMA argues that such a drop in the Medicare acceptance rate could “potentially cause a catastrophic backlog of millions of unpaid Medicare claims.”
And, since the end-to-end testing represents less than 1 percent of all Medicare claims, representing providers who were significantly more prepared for the transition than their peers (due to the nature of the pilot), the reality of the drop could be much greater.
“The likelihood that Medicare will reject nearly one in five of the millions of claims that go through our complex health care system each day represents an intolerable and unnecessary disruption to physician practices,” AMA President Robert M. Wah, M.D. stated. “Robust contingency plans must be ready on day one of the ICD-10 switchover to save precious health care dollars and reduce unnecessary administrative tasks that take valuable time and resources away from patient care.”
“We are concerned the administration is underestimating the impact the transition to ICD-10 will have on the regulatory tsunami that is already burdening physicians and threatening access to quality care,” Dr. Wah concluded. “Although we appreciate the training, educational tools and other efforts by CMS to prepare physicians for the ICD-10 transition, it is clear that more information is needed about how the shift will impact quality reporting so physicians can avoid penalties.”