AAFP Joins Dozens of Physician Groups Urging CMS to Halt ICD-10 Implementation

On Dec. 20, an AMA-inspired letter (3-page PDF; About PDFs) signed by the AAFP and nearly 40 other national physician organizations was sent to CMS Acting Administrator Marilyn Tavenner, M.A., with a simple but firm request: Stop implementation of the ICD-10-CM code sets for outpatient diagnosis coding.

The implementation date for ICD-10 is set for Oct. 1, 2014, but dozens of physician groups continue to argue that America's physicians should not be forced to shoulder the burden the new code sets will create, especially at a time when they are overwhelmed with health care system demands and changes.

The AMA-instigated action came at the request of its membership and states this clear position: "As you are aware, the American Medical Association's (AMA) House of Delegates approved new policy in November 2012 calling on the AMA to advocate that the Centers for Medicare & Medicaid Services (CMS) eliminate the implementation of ICD-10 and to immediately reiterate that the burdens imposed by ICD-10 will force many physicians in small practices out of business."

Furthermore, says the letter, "Stopping the implementation of ICD-10 is a critical, necessary step for removing regulatory burdens on physicians and ensuring that small physician practices are able to keep their doors open."

The letter points out that implementation of ICD-10 will create significant burdens on physicians yet will have no direct benefit on individual patient care. ICD-10 will increase the number of outpatient diagnostic codes from around 13,000 to more than 68,000.

"This is a massive administrative and financial undertaking for physicians," says the letter, adding that implementation will require many hours of education, training and testing. "Physicians will be responsible for all of these costs, which, depending on the size of a medical practice, will range from $83,290 to more than $2.7 million."

Moreover, argue the organizations, the timing of the ICD-10 transition is terrible. Physicians are dedicating large amounts of time and money to implement electronic health records (EHRs), and they face financial penalties if they don't successfully participate in a myriad of Medicare programs, including e-prescribing, EHR meaningful use, the Physician Quality Reporting System and the value-based-modifier initiative.

The letter points out that these competing pressures on physician practices could have a negative impact on physicians' ability to participate in new health care delivery and payment reform models "intended to support higher quality, lower cost and more efficient care."

The letter calls on the Obama administration to work with physicians to develop a roadmap that outlines all of the various federal requirements related to physicians in practice "to ensure that the timelines are synchronized to the greatest degree possible to minimize the burdens on physicians."

"Stopping the implementation of ICD-10 and calling on appropriate stakeholders to assess an appropriate replacement for ICD-9 will help keep adoption of EHRs and physician participation in delivery and payment reform models on track and reduce costly burdens on physician practices," concludes the letter.