Call to Halt ICD-10 Puts New Angle on Demand for Physicians

The American Medical Association’s most recent call to halt implementation of ICD-10 codes brings to light an interesting angle to the coding story – one that I hadn’t recognized until I read up on just why the AMA has consistently made it known that the switch is a bad idea.

The association believes transitioning to the new, 68,000 codes will place too much of a financial and administrative burden on physicians (especially small practices), and will ultimately force many of them to shut their doors.

Attending education sessions at AHIMA last fall left me with the impression that though learning the new codes and suffering through dual coding wouldn’t be fun, they would ultimately help physicians and hospitals receive proper reimbursement for their services. Yes, there were vendor cheerleaders on many panels, but the logic made sense even to a novice like me.

I realize that physician practices are quite a different kind of beast when it comes to handling administrative tasks, and I can certainly understand how a small practice would feel completely overwhelmed when, as the AMA stated in a letter to CMS, overlapping federal regulations combined with predicted Medicare pay cuts will make switching to ICD-10 a huge difficulty for them.

But I feel as if there’s a catch 22 here. If physicians don’t make the switch, they won’t see the potential financial benefits of more accurate coding. If they do make the switch, they’ll likely face such huge financial strains that they’ll opt to go out of business. Are there any physician readers out there who are cheerleading the ICD-10 switch?

It occurred to me, reading recently about the predicted banner year for physicians seeking hospital employment, that physicians that do decide to close their doors as a result of ICD-10 may contribute to this glut of MDs looking for work.

Perhaps there’s a domino effect waiting to happen – CMS stands firm on the ICD-10 deadline / Physicians work incredibly hard to try and make it happen. / Physicians fail and go out of business, or decide early on that it’s just not worth the trouble and close up shop. / Said physicians seek hospital employment. / There aren’t enough hospital jobs to go around and many MDs are left in the unemployment line.

That’s just one scenario I’ve been mulling over, and of course doesn’t take into consideration the large amount of other challenges facing physicians right now. What’s your take on the ICD-10 and physician staffing situation?

About the author

Jennifer Dennard

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

4 Comments

  • OR, physician practices realized they can’t succeed on their own, hire knowledgeable consultants or revenue cycle management firms to help manage and ease the the process, stay in business and thrive, and be able to hire the unemployed physicians unable to find employed work at a hospital.

    I believe that the perfect storm of ICD10, PQRS, MU and HIX is going to force small practices to reconsider their practice operations and processes, realize that they’re running a business, and seek relationships with professionals providing service offerings that will help them overcome the industry storm and come out in a healthier financial state than they had been in previously. Physicians hire accountants to do their taxes, bankers to handle their investments, transcription services to handle their dictations, but often leave their revenue cycle to be handled in house. It’s not going to work for much longer.

  • I have worked in the healthcare industry for more than 20 years. Like many, I have witnessed a variety of evolvement in the industry. So changes is nothing new. In truth, I think the conversion to ICD-10-CM in the physician environment is overrated. It appears to be a tactic to birth fear in their ability to exist in the world of ICD-10. Lack of education has the tendency and power to incite fear of the unknown. Simply put, it is not a daunting task for the small physician environment. Basically, you only concentrate on the ICD code sets that you currently use and make certain you have developed effective processes and clinical documentation. Don’t allow the new 60,000+ new code sets create any intimidation because all of it is not your concern. Secondly, you don’t have to worry about ICD-10-PCS because it is only applicable to in-patient services. Particular organizations need to stop scaring the healthcare industry. With regard to EMR, locate the nearest REC in your area to discover if you qualify for financial assistance with the software implementation, which could position you to qualify for additional governmental incentives with meeting meaningful use. But you must act FAST!!! If you should have any questions, please feel free to reach out to me at (407)459-5926, I will provide you guidance. Again, to those it may apply, please refrain from causing unnecessary fear in the small physician environment. Their service is needed to provide optimal care to us. Thank you-

  • Jennifer,

    There is a lie that won’t go away. It was created by CMS to help justify their campaign to implement ICD-10 CM.

    That lie is that physician payments will be improved when I-10 is implemented. I-10 may improve HOSPITAL payments – their payments are based on diagnosis codes. But I-10 has NO such favorable effect on physician payments because they’re paid on CPT codes.

    If I-10 is implemented FLAWLESSLY by all parties – software vendors, EMRs, providers, coders, clearinghouses, payers, government programs, etc. – the best possible outcome is that physician payments will remain the same and no new denials will occur. What are the odds of a flawless implementation? ZERO.

    When I spoke at AHIMA’s 1st ICD-10 Summit in 2009 I got into a lot of trouble for telling the truth (the AMA caught up years later) when I said, “All pain, no gain.” It’s still true.

    If it’s going to be done, it’s going to be done. But do not pretend that there’s something good at the end of that Shades of Grey rainbow ~ there isn’t.

    I’m also puzzled by your comments about “unemployed physicians” since we have a national shortage of doctors and the ACA will compound that in less than a year when tens of millions of Americans acquire coverage and can finally consider going to a doctor for the ailments and preventative care they’ve been “saving up.” What happened in Mass.? There was a rush of new demand and no new providers, pressing existing providers and flooding the ERs.

    Younger physicians are more comfortable with employment than their predecessors – for lifestyle reasons. But practices ruined by the avalanche of regulatory unfunded mandates and potential penalties for not engaging in Medicare’s meaningless incentive programs will find other ways to prevail.

    Back in the good (really) old days, doctors were paid in cash and patients had to bill their insurance. Everyone seems to think that physicians are required to bill insurance ~ they’re not. Relying on the recent history of courtesy billing overlooks that fact (they can even opt-out of Medicare) and extreme changes can provoke extreme responses. Such radical developments would be traumatic for everyone, but sick humans need doctors willing to care for them and a short supply creates the opposite of physicians struggling to find a job.

    Hospitals have a terrible track record of operating medical practices, as demonstrated 15 years ago during the long-gone HMO era. The paradigm has shifted some, but hospitals are not smarter now than they were then and those who failed before have all been replaced by new CEOs, CFOs, CMOs, etc. who will re-make their predecessors’ mistakes.

    ICD-10 is really good for researchers, epidemiologists and pharmaceutical companies – and the long parade of software vendors, consultants, trade associations and others selling “solutions” and “help” (I have deliberately eschewed being one of them). It may offer some benefits to hospitals. There are NO benefits to physicians – only costs, reduced productivity and business risks.

    As for unemployed physicians – if you have a list, I’d love to buy it. I know a LOT of communities that can’t find what they need.

    Bob Burleigh CHBME
    Brandywine Healthcare Services
    West Chester, PA

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