Health Information Management

News: AMA proposes ICD-10 payment two-year grace period

CDI Strategies, June 25, 2015

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The American Medical Association (AMA) made another attempt to delay ICD-10 recently, but the delay wasn’t of code-set implementation, however, but of its impact post-implementation.

Physicians at the 2015 AMA Annual Meeting on June 6-10, passed a policy calling for CMS to put a two-year moratorium on payment penalties for physicians as a result of ICD-10 coding mistakes. The proposed grace period would essentially hold hospitals accountable for the ICD-10 codes they report, but physicians would not be penalized for “errors, mistakes, and/or malfunctions of the system.”

The resolution further instructs the AMA to seek data on how ICD-10 implementation has affected patients and changed physician practice patterns, and to educate members on ways to cancel payer contracts and move to all-cash practices. The AMA promotes this cash-only option for practices as a method to protect patients’ access to care.

The AMA also wants to become one of the four Cooperating Parties—currently, the Centers for Disease Control National Centers for Health Statistics, CMS, the American Hospital Association, and the American Health Information Management Association—which manages and updates the ICD code set, in an attempt to bring more physician voices to the ICD-10 table.

The ICD-10 Coalition released their response to the AMA proposal on June 14, saying the proposed “safe harbor” is “unnecessary” and could potentially have “dangerous consequences.” The coalition says ICD-10 diagnoses do not impact physician payment, and will not require a burdensome amount of additional clinical detail from the physicians. Overall, the ramifications of such a delay could include fraud and abuse, incomplete documentation, and widespread system disruptions.

Read the full report by the AMA here.

Read the ICD-10 Coalition’s response here.

Editor’s Note: Portions of this article were compiled from the ACDIS Blog. To read more, click here. 



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