CMS and AMA Unite in the Face of ICD-10: A New Hope

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CMS and AMA Unite in the Face of ICD-10: A New Hope

CMA and AMA issued a press release detailing their plans to aid providers with ICD-10 transitions. The AMA has traditionally been opposed to ICD-10 implementation. Also some still feel though that this positive force for ICD-10 will not be enough to ensure a smooth transition.

CMA & AMA Issue Press Release

On Monday, the Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) issued a press release announcing their plans to aid providers as they begin to make the transition to ICD-10.

It’s surprising to see the AMA associated with such a positive message as they have been arguing against ICD-10 for years. Healthcare IT News listed many such instances in a recent article, including former AMA President Robert Wah’s Star-Wars related jab, “If it was a droid, ICD-10 would serve Darth Vader.” Perhaps, this communion between the two organizations will help relieve some of the tension ICD-10 has created.

As a part of their efforts, CMS has offered some flexibility in the transition process. They listed out the plans they will be executing in the coming months, which include:

  • Creating an ICD-10 communications and coordination center
  • Notifying Medicare fee-for-service providers of flexibilities in July
  • Finishing Medicare end-to-end testing in July
  • Providing Medicare acknowledgement testing through September 30th
  • Offering in-person training using “Road to 10” for small physician practices
  • Hosting an MLN Connects National Provider Call on August 27th

The following provisions will also be made in order to ensure that physicians are not penalized as they adjust to the new coding system.

  • An ICD-10 Ombudsman will be appointed to investigate complaints and work closely with CMS reps to address physician concerns
  • For 1 year, Medicare will not deny claims based on the specificity of ICD-10 diagnosis codes as long as a valid code from the right family is used. This does not mean that ICD-9 codes can still be used. Beginning October 1st, 2015, “a valid ICD-10 code will be required on all claims.”
  • The Physician Quality Reporting System, Value Based Modifier, and Meaningful Use 2 will not penalize physicians if an incorrect code is used, again, as long as they have used a code from the right family.
  • Advance payments will be made available in the case that Medicare cannot process the claims in time due to administrative problems.

Carl Natale, ICD10 Watch Editor, doesn’t feel these efforts are going to be enough. According to Natale, “this is a move to placate U.S. Representatives and Senators who are demanding that CMS do something to protect the independent physicians.”

He is not the only one to disagree. Despite the AMA’s seeming change of heart, many physicians remain steadfast in their fight against ICD-10. In response to the CMS announcement, on Tuesday, the American Society of Interventional Pain Physicians (ASIPP) released an email expressing their discontent. Dr. Peter Staats, ASIPP President, and Dr. Laxmaiah Machikanti, ASIPP CEO and Chairman of the Board, urged their fellow physicians to send letters to Congress as part of their campaign to postpone implementation of ICD-10. It is unclear how this situation will play out, so whichever side you are on, “may the Force be with you.”


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Author: Apoorva Anupindi

2 thoughts on “CMS and AMA Unite in the Face of ICD-10: A New Hope

  1. The implementation cost of ICD 10 is said to be very high. The more the number of physicians in a clinic, the higher the cost. AMA has at present asked them to halt the launch of ICD 10 and instead create a placement for ICD 9 with a few changes in the basic coding structure

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