Many smaller physician practices could go out of business due to problems associated with the fast approaching ICD-10 conversion. There are about 68,000 diagnostic codes under the new ICD-10-CM codes, which is five times more than under ICD-9-CM. A recent MGMA survey found that, "9.2% of physician groups were still using an electronic data transmission format incapable of carrying the new ICD-10 codes."
During an online conference in late August, acting CMS Administrator Andy Slavitt, whose agency mandated the switch to ICD-10, acknowledged the uncertainty. The CMS has allowed four state Medicaid programs to use a workaround, called a crosswalk system. A crosswalk is a computer text file with ICD-9 codes in one column and corresponding ICD-10 codes in another, allowing for easier payment calculations. Crosswalks, however, can compromise data quality because many codes don't map to similar concepts.
A Texas Medical Association survey found that payment delays linked to ICD-10 could force some physician practices to close or push older physicians into retirement. Physicians groups are particularly vulnerable to cash-flow crunches because federal tax rules don't allow them to hold cash reserves. There will be huge financial consequences for groups that have put off preparing as well as updating their technical capabilities for ICD-10. Experts warn that revenue streams even at the largest and most well-prepared organizations could be constricted for months following the Oct. 1 switch.
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