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Docs’ Group: ICD-10 Date Won’t Work


August 19, 2008

The Medical Group Management Association has pronounced the Centers for Medicare and Medicaid Services’ proposed Oct. 1, 2011, compliance date for the ICD-10 code set as unworkable.

“The proposed regulation simply does not give the industry the time necessary to implement ICD-10,” MGMA president and CEO William Jessee, M.D., said in a statement on Aug. 19.

The proposed rule, to be published soon in the Federal Register, also calls for adoption of version 5010 of the HIPAA transactions sets by April 1, 2010 (see story, here).

Jessee, however, said migrating to ICD-10 “has the potential to be the most complex change for the U.S. health care system in decades.” Further, the Englewood, Colo.-based organization of group practice administrators believes CMS should wait at least three years after the conversion to 5010 before moving the industry to ICD-10.

A recent MGMA survey found 95% of medical practices would have to purchase software upgrades or entirely new practice management systems to comply with ICD-10. In addition, 63.5% of respondents anticipated having to buy code-selection software and 83.5% believed insurers won’t be ready to accept claims with ICD-10 codes by October 2011.

“As we have seen with the protracted implementation of other requirements of HIPAA, such massive system and workflow changes necessitate coordinated actions among medical groups and their vendors, clearinghouses and health plans,” Jessee said. “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.”

MGMA in June sent a letter to CMS acting administrator Kerry Weems opposing a rapid transition to ICD-10. “Before any move to ICD-10, there must be a national implementation plan, a cost-benefit analysis, code set crosswalks, and full implementation of the HIPAA 5010 standards,” according to the letter.

The organization also in September 2006 joined dozens of other physician groups in pushing Congress to delay ICD-10 implementation. At the time, health information technology legislation before lawmakers would have mandated ICD-10 adoption by October 2010. The associations, in a letter to congressional leaders, urged that if a bill was passed, it not include a compliance date “at least prior to 2012.”

Last December, two advocacy organizations released a regulatory timeline that estimated a 2014 completion date necessary for the HIPAA 5010 transactions if a proposed rule was issued in June 2008.

The timeline from the North Carolina Healthcare Information and Communications Alliance and the Workgroup for Electronic Data Interchange, covered nearly 20 major processes and several sub-processes that needed to be completed to implement 5010. The single process of vendor development and implementation--with eight sub-processes--was estimated to take 472 days. The timeline is available at nchica.org.

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