Dive Brief:
- The American Medical Association and 99 medical specialty societies expressed concerns about the lack of a contingency plan for ICD-10 in a March 4 letter to Centers for Medicare and Medicaid Services acting administrator Andrew Slavitt.
- The letter claimed that ICD-10 failures could result "in a significant, multi-billion dollar disruption for physicians and serious access-to-care issues for Medicare patients."
- The American Health Information Management Association (AHIMA) says that the physicians' fears are understandable, but unfounded.
Dive Insight:
In a March 4 statement, the physician groups said that recently-released end-to-end testing results showed that the claims acceptance rate would fall from 97% to 81% if ICD-10 was implemented today. "That change in Medicare's acceptance rate could potentially cause a catastrophic backlog of millions of unpaid Medicare claims," the statement says. "Because the testing only represents less than 1% of all Medicare claims and likely involved providers who are significantly more prepared for ICD-10 than many of their peers, the acceptance rate could actually be much worse."
Sue Bowman, AHIMA's senior director for Coding, Policy and Compliance, told HealthLeaders Media that the end-to-end testing that CMS conducted in January demonstrates that the government is "definitely ready."
"The letter talks about only 81% were accepted and processed and were not rejected in the January testing," Bowman said. "What is not said is that if you read the testing results the vast majority of the erroneous claims had nothing to do with ICD-10. They were the wrong codes or NPI information. Only 3% of the rejected claims had anything to do with ICD-10. That makes it more like 97% if you are looking solely at the ICC-10 risk issues."