ICD-10 could put many small physician practices out of business, coalition contends

January 7, 2013

Nearly 40 national physician groups are calling on the Centers for Medicare and Medicaid Services (CMS) to quash implementation plans of the International Classification of Diseases – 10th Revision (ICD-10) for outpatient diagnosis coding.

 

Nearly 40 national physician groups are calling on the Centers for Medicare and Medicaid Services (CMS) to quash implementation plans of the International Classification of Diseases – 10th Revision (ICD-10) for outpatient diagnosis coding.

The groups argue that physicians should not have to shoulder the economic and management burdens the new code set creates, reports the American Academy of Family Physicians (AAFP). ICD-10 is expected to increase the number of diagnostic codes nearly five-fold - from 13,000 to 68,000.

In a letter to CMS Acting Administrator Marilyn Tavenner, the American Medical Association (AMA)-led coalition argues that this new disease classification system will force many physicians in small practices out of business without a direct benefit to patient care.

The AMA argues that depending on the size of the medical practice, the costs to implement ICD-10 are estimated from $83,290 to more than $2.7 million per practice.

And the October 1, 2014, implementation date is coming at a time when doctors face steep payment cuts due to an unresolved sustainable growth rate formula and another 2% sequestration cut to Medicare reimbursements due to deficit reduction measures. Factor in future penalties for failing to attest to meaningful use, value-based modifier programs and Physician Quality Reporting System penalties, and it simply compounds the economic pressure for physicians, the groups say.

"The timing of the ICD-10 transition could not be worse, as many physicians are currently spending significant time and resources implementing electronic health records into their practices," the groups say.