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Mississippi physicians offer olive branch on code requirements

Dr. Claude Brunson

Dr. Claude Brunson


Mississippi physicians are willing to throw themselves on the mercy of the federal government as a Oct. 1 deadline nears for the implementation of a complex disease coding system they say is a disruptive threat.

The system is called ICD-10. That stands for the 10th version of the International Classification of Diseases.

The codes have grown — to 68,000 from 13,000 — in this version of the system, said Dr. Claude Brunson, president of the Mississippi State Medical Association. ICD-9,  which has been in place for 36 years, required the addition only only a few hundred codes.

The federal Health and Human Services Department has already delayed the new codes for two years to give physicians, hospitals and other care givers time to master them. The codes are more precise and are designed to render better health care for that reason.

But the plethora of codes increases the chances of mistakes.

“Our physician offices already have thin margins,”  Brunson said in an interview. “They cannot afford to have a disruption of the payment in their practices.”

“There may be months before we get reimbursed for the care that we’ve provided,” Brunson said.

So the association on Friday sent a letter to the state’s congressional delegation asking for support of a two-year grace period during which the insurers, whether private or government, would pay first and get clarification, if necessary, later.

“We’re not asking for a delay, we’re asking for a grace period,”  Brunson said in the interview.

The approach that the state association is taking is similar to the American Medical Association’s position.

The national group voted earlier this month in Chicago at its annual meeting to ask the Centers for Medicare and Medicaid Services not to withhold claim payments based on coding errors, mistakes or malfunctions in the system for two years, according to the AMA Wire.

Two bills have been introduced in Congress on behalf of the medical community. A bill sponsored by U.S. Rep. Ted Roe, R-Texas, calls for blocking the rollout. Another, sponsored by Rep. Diane Black, R-Tenn., calls for an 18-month transition period with testing of the new code.

A recent survey found that only 11 percent of respondents were “highly confident” their staff will be sufficiently trained by the  deadline to move to the new code set; 35 percent said they were “not at all confident” their staff will be ready, according to FierceHealthIT.

Black wrote in a letter urging fellow legislators to co-sponsor the bill that “neither Congress nor the provider community support kicking the can down the road and supporting another delay, but we must ensure the transition does not unfairly cause burdens and risks to our providers, especially those serving Medicare patients,”  the publication reported.

The Centers for Medicaid and Medicare Services announced that testing of 23,000 claims had an 88 percent success rate. But there will be millions of claims when the new code is implemented.

Brunson said that the government painted a positive anticipatory picture of the rollout of the Patient Protection and Affordable Care Act, but when that happened, the healthcare.gov crashed within minutes.

The ICD-10 deadline comes on the heels of another major change, conversion from paper records to electronic in which practices, hospitals and other care givers had to show a “meaningful use” of the new method by this year or face Medicare penalties.


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