The American Medical Association and 99 state and specialty societies are calling for the Centers for Medicare and Medicaid Services to have contingency plans in place to address potential financial and care issues from the Oct. 1 transition to ICD-10 coding, according to the AMA.
The groups are worried about anticipated failures resulting in a significant, multibillion dollar disruption for physicians and serious access-to-care issues for Medicare patients, the groups said in a letter sent to the CMS on Wednesday.
Recently released end-to-end testing by the CMS showed 81 percent of claims using ICD-10, though many of those errors were tied to issues with how the test was set up.
[Also: ICD-10 passes end-to-end testing]
However, the AMA used that figure to show how a Medicare acceptance rate of 81 percent could potentially cause a catastrophic backlog of millions of unpaid Medicare claims. Medicare could reject nearly one in five claims, physicians said.
Many doctors have spoken against an Oct. 1 switchover to the new coding system, while most hospital administrators have said they are testing and ready for ICD-10.
The AMA and other groups are calling for the CMS to also consider how the transition to ICD-10 will impact quality reporting programs such as the Physician Quality Reporting System and Meaningful Use.
[Also: 6 tips for preparing for ICD-10]
Because the quality reporting periods are based on the calendar year and the switch to ICD-10 will be occurring more than three quarters into the year, the quality measures for 2015 will be reported and tabulated with both ICD-9 and ICD-10 codes, according to the AMA. This will especially be problematic for measures that capture encounters pre- and post visit for services that straddle the Oct. 1 transition deadline, the AMA said.
Twitter: @SusanMorseHFN