AMA Calls For Blocking Required Coding Change To Reduce Unnecessary Practice Expenses

One of the many reasons that health care costs so much is that billing is an enormous expense for physician offices and all health care facilities.  There are complexities to billing for services in health care which are not present in most industries. If most people want to send out a bill, they can just list the services in plain English. In health care everything has a number, both for the diagnosis and for the services provided. The current ICD-9 diagnosis system used in the United States uses up to five digits to describe every medical problem. Much of the world has already changed to ICD-10, which has a whole new set of codes and goes out to six digits, allowing for even greater specificity.  The United States plans to convert in October, 2013, resulting in a tremendous increase in medical practice expenses.

Bureaucrats think that the five digit numbers are not enough and we need six digit numbers to describe more exactly what diagnosis is involved. They don’t seem to have questioned whether this degree of specificity is needed, or if the results they get are accurate. It is somewhat like the game of telephone. By the time diagnoses go from the doctor, who writes them in English, through staff members and on to the payers, many inaccuracies enter into the system. Any type of study based upon ICD-9 codes is likely to have a tremendous amount of erroneous data.  The ICD-9 codes typically have choices for the fifth digit of “other” or “unspecified” which are commonly used. This practice will continue, defeating the purpose of adding yet a sixth digit to describe a diagnosis.  Besides, if anyone really needs to see the exact details before paying, they could always review the actual notes (as  is commonly done by payers such as auto insurance and workers compensation).

The ICD-9 system is in place and is working. In an era of trying to cut unnecessary expenses it is foolish to spend the money it would take to convert to ICD-10. The goal should be to reduce complexity to reduce costs, not to increase complexity or to require costly changes. The AMA House of Delegates voted today to attempt to block the implementation of ICD-10.

The AMA House of Delegates voted today to work vigorously to stop implementation of ICD-10 (The International Classification of Diseases and Related Health Problems, 10th Revision), a new code set for medical diagnoses. ICD-10 has about 69,000 codes and will replace the 14,000 ICD-9 diagnosis codes currently in use.

“The implementation of ICD-10 will create significant burdens on the practice of medicine with no direct benefit to individual patients’ care,” said Peter W. Carmel, M.D., AMA president. At a time when we are working to get the best value possible for our health care dollar, this massive and expensive undertaking will add administrative expense and create unnecessary workflow disruptions. The timing could not be worse as many physicians are working to implement electronic health records into their practices. We will continue working to help physicians keep their focus where it should be — on their patients.”

A 2008 study found that a small three-physician practice would need to spend $83,290 to implement ICD-10, and a 10-physician practice would spend $285,195 to make the coding change.

As noted above, the timing is especially bad as the government is now pushing medical offices towards changing to electronic medical record system. Such implementation is made more difficult when the systems have to be set up to handle ICD-9 until October, 2013 and then abruptly change to an entirely new system. Besides the costs resulting from changing system, the government is also requiring a change in electronic billing formats in January, 2012 which is also causing added expense.

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