AMA Seeks Two Year Grace Period for ICD-10 Coding Errors

AMA Seeks Two Year Grace Period for ICD-10 Coding ErrorsAMA House Delegates Also Support Skipping ICD-10 All Together

The American Medical Association (AMA) House of Delegates held its annual meeting last week in Chicago. Tackling a full plate of issues including a call for a crack down on misleading medical device ads and adopting cautions to keep pharmacists from intruding on medical practices (, the Delegates voted to push and lobby for a two year grace period on denied payments to physicians for ICD-10 coding errors.

From the page 46 of the preliminary report of actions taken by the House of Delegates at its 2013 Annual Meeting:

RESOLVED, That our American Medical Association support federal legislation to mandate a two-year “implementation” period by all payers, including CMS, if ICD-10 or ICD-11 is implemented. During this time, payers will not be allowed to deny payment based on 8 specificity of ICD-10/11 diagnosis. However, they will be required to provide feedback for incorrect diagnosis. In addition, no payer will be allowed to ask for “takebacks” due to lack of ICD-10/11 diagnosis code specificity for the aforementioned two-year implementation period.

The vote continues AMA’s battle to halt or significantly change the mandatory transition from ICD-9 code sets to ICD-10. The compliance date for this transition is scheduled for October 1, 2014. The transition to ICD-10 is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA). The current compliance date has already been pushed back from its original October 1, 2013 with the release of the HHS  Final Rule delaying ICD-10 compliance to the current October 1, 2014.

From the preliminary report:

Resolution 236 asks 1) that our American Medical Association educate US physicians on the burdens of ICD-10 and how our AMA is fighting to repeal the onerous ICD-10 requirements on their behalf; and 2) that our AMA support federal legislation to stop the implementation of ICD-10 and remain with ICD-9 until ICD-11 can be properly evaluated. (Directive to take Action.

Of great interest here is item two. In May of this year the AMA released a report from its Board of Trustees voicing opinion that skipping over ICD-10 to move directly to ICD-11 is not an option. The report is a follow up to the AMA’s House of Delegates request at the AMA 2012 Annual Meeting for an evaluation of the feasibility of moving from ICD-9 to ICD-11, skipping ICD-10 all together. In addressing AMA’s long held position against the mandated implementation of ICD-10, the report acknowledges the one year delay by HHS issued last August to push the compliance date to October 1, 2014 was a good compromise. The Delegates have clearly now rejected their own organization’s report.