Otolaryngology Coding Alert

Here's why CMS will ignore the AMA's endorsement.

The American Medical Association (AMA) has made no secret of the fact that it is less than enthralled with the proposition of adopting ICD-10 as the new diagnosis coding system. Not only did the AMA's House of Delegates vote last year to repeal ICD-10 (which CMS did not adopt), but the group also applauded the news earlier this year that ICD-10 would be delayed from its original implementation date of 2013.

Now the AMA has taken additional steps to express its disillusionment with ICD-10, announcing on June 19 that its House of Delegates adopted a policy to evaluate ICD-11 as a potential "alternative" to replace ICD-9, an AMA news release noted.

Despite endorsement of a direct move to ICD-11 from the American Medical Association and others, don't be surprised to see CMS ignore that advice. "It took the U.S. eight years to adapt the WHO version of ICD-10 and create ICD-10-CM for use in this country," the American Health Information Management Association (AHIMA) counters in a recent article.

"Regardless of the benefits of ICD-11, the U.S. would need a national version to allow for the annual updating required by Congress and U.S. stakeholders. Assuming that the development timeline for a national version or clinical modification of ICD-11 could be cut in half down to four years, it would then take an additional two years to get through the HIPAA rulemaking process. As with ICD-10-CM/PCS, the industry would want at least a three-year period for converting systems to ICD-11," the AHIMA article says.

End result: "Assuming that ICD-11 becomes available on schedule from WHO in 2016, then the earliest the U.S. could move to ICD-11 would be 2025, or 13 years from now," the AHIMA article points out.