AMA refuses to accept ICD-10 implementation again

Carl Natale
by Carl Natale

When the American Medical Association's (AMA) House of Delegates met last week, its ICD-10 decisions were overshadowed by statements on obesity and guns.

The first decision called for a "two-year implementation period for ICD-10/11." The AMA does not want healthcare payers to deny medical claims because of medical coding error or use of not-so-specific medical codes.

I'm not sure how that would work in practice. But it almost sounds like the HIPAA 5010 non-enforcement period granted by the Centers for Medicare and Medicaid Services (CMS) in 2012. Almost.

Here's the wording from the policy:

"RESOLVED, That our American Medical Association support federal legislation to mandate a two-year “implementation” period by all payers, including CMS, if ICD-10 or ICD-11 is implemented. During this time, payers will not be allowed to deny payment based on  specificity of ICD-10/11 diagnosis. However, they will be required to  provide feedback for incorrect diagnosis.  In addition, no payer will be allowed to ask for “takebacks” due to lack of   ICD-10/11 diagnosis code specificity for the aforementioned two-year 13 implementation period."  — From Committee B reference report

What's really interesting is that statement is an amendment to Resolution 236 that rejects the Board of Trustees report that would have ended leapfrogging into ICD-11 implementation .

[See also: Is the AMA going to learn to stop worrying and love ICD-10 implementation?]

This means the AMA is again vigorously opposing ICD-10 implementation:

"Resolution 236 asks 1) that our American Medical Association educate US physicians on the burdens of ICD-10 and how our AMA is fighting to repeal the onerous ICD-10 requirements on their behalf; and 2) that our AMA support federal legislation to stop the implementation of ICD-10 and remain with ICD-9 until ICD-11 can be properly evaluated. (Directive to take Action)"

Basically the AMA voted to reject the report that said that waiting for ICD-11 implementation would create more problems than it would solve and reaffirm Policy D-70.952:

"1. Our AMA will: (A) vigorously work to stop the implementation of ICD-10 and to reduce its unnecessary and significant burdens on the practice of medicine; (B) do everything possible to let the physicians of America know that our AMA is fighting to repeal the onerous ICD-10 requirements on their behalf; (C) work with other national and state medical and informatics associations to assess an appropriate replacement for ICD-9; and (D) evaluate the feasibility of moving from ICD-9 to ICD-11 as an alternative to ICD-10 and report back to the House of Delegates.

"2. In order to alleviate the increasing bureaucratic and financial burden on physicians, our AMA will vigorously advocate that the Centers for Medicare & Medicaid Services eliminate the implementation of ICD-10.

"3. Our AMA will immediately reiterate to the Centers for Medicare & Medicaid Services that the burdens imposed by ICD-10 will force many physicians in small practices out of business. This communication will be sent to all in Congress and displayed prominently on our AMA website. (Sub. Res. 216, I-11; Appended: Res. 236, A-12; Appended: Res. 209, I-12)"

What's troubling about this rejection is that the rejected report recommended helping physicians with ICD-10 compliance. Instead it looks like they're recommending physicians cover their ears and scream, "Nah nah nah nah nah nah nah nah nah nah."

It's kind of like when a physician dedicated to treating patients tries to give a young child an inoculation. If the child resists and cries, the physician says, "OK, we're going to skip the shot and wait for medicine that tastes like root beer floats."