ICD-10 debuts, angers doctors already

When Joseph Valenti, MD, said on October 1 that ICD-10 is another administrative burden strangling independent practices he was perhaps representative of a common feeling among doctors. 

"ICD-10 is a symptom of a bigger problem," said Valenti, an independent physician and a member of the Physicians Foundation. "It's an attack on private doctors. (We have) evidence-based medicine. I think everyone needs to practice evidence-based regulation, evidence-based regulation that helps doctors take care of patients, that makes for a more efficient health system. This does none of that. It's going to cause a bunch of claims to be denied."

The American Medical Association has been a vocal opponent of the move to ICD-10 with AMA President Steven Stack, MD saying this spring the switch should wait until ICD-11. The AMA got onboard with the Oct. 1 conversion after the Centers for Medicare and Medicaid said it would grant a year's grace period and pay Medicare Part B claims as long as they were submitted in the correct family of codes.

"It's not just that the codes are changing, but what codes go with other codes. It's not just the language, it's the rules," Valenti said.

For instance, in obstetrics, he said, for every health procedure reported, a doctor must now code the number of weeks of pregnancy, or risk having the claim denied.

"It doesn't help the patient, it doesn't help us," he said of having to code that information. "When we went to the electronic medical record, it slowed us down to half speed for six months. This is going to slow us down more. It's a crazy environment. What we did go to school for?"

Every year independent doctors close their businesses, he said.

"Doctors are in the top 10 frequently noted businesses in bankruptcy," Valenti said. "That's frightening."

Some independent docs are conspiracy theorists who believe regulations are forcing them into the fold as employees, he said.

"The erosion of clinical autonomy is a concern," he said. "A large group of doctors feel it's part of the plan. The more you make doctors unable to be autonomous, the easier they are to control."

Twitter: @SusanJMorse