Ask Congress to Postpone Implementation of ICD-10-CM

The implementation date for ICD-10-CM is scheduled for Oct. 1, 2015. Did you know that the rest of the world will not be using ICD-10-CM making our data useless because it will not match other countries? And did you know that the implementation of ICD-10-CM will require physicians and their staff to transition to a system that makes use of 68,000 new codes?

As we all know, physicians in the United States are already drowning in a regulatory tsunami. Now physicians face the threat of ICD-10-CM implementation with unfunded mandatory requirements. ICD-10 implementation is based on a liberal interpretation of a weak clause in HIPAA that actually only requires an update to ICD-9 and says nothing about ICD-10 or beyond. Further, the highly regulated health care industry has been handed over to an under-regulated health information technology (IT) industry and various other providers in health care.

Since Congress has been unwilling to delay the implementation day of Oct. 1, 2015 for ICD-10-CM, ASIPP began an aggressive campaign this week to reach out to legislators asking them to postpone ICD-10-CM by contacting multiple senators and representatives.

It is important that each physician and staff send a letter right away. We have very little time to convince Congress to act. We have set up a letter in Capwiz to make this easy for everyone.

• Click on the link for Word version of the letter if you prefer to send a personalized letter in the mail.
• Click on the this link to send your letter through Capwiz
• Click here for more updated facts on ICD-10-CM

This is an easy way to make a huge impact! Please commit to joining us in this important letter writing campaign asking Congress to delay this unfunded implementation. We need the full support and action from our members.

Join us in our efforts by sending your letters today!

CMS Announces ICD-10 Grace Period: CMS will reimburse ICD-10 mistakes for one year after transition deadline

The Centers for Medicare and Medicaid Services (CMS) announced that an agreement has been reached on important elements of a "grace period" for the October 1, 2015, implementation of the ICD-10 diagnosis code set.

In guidance that is being transmitted today, CMS announced that:

For a one year period starting October 1, Medicare claims will not be denied solely on the specificity of the ICD-10 diagnosis codes provided, as long as the physician submitted an ICD-10 code from an appropriate family of codes. In addition, Medicare claims will not be audited based on the specificity of the diagnosis codes as long as they are from the appropriate family of codes. This policy will be followed by Medicare Administrative Contractors and Recovery Audit Contractors.

To avoid potential problems with mid-year coding changes in CMS quality programs (PQRS, VBM and MU) for the 2015 reporting year, physicians using the appropriate family of diagnosis codes will not be penalized if CMS experiences difficulties in accurately calculating quality scores (i.e., for PQRS, VBM, or Meaningful Use). CMS will continue to monitor implementation and adjust the duration if needed.

CMS will establish an ICD-10 Ombudsman to help receive and triage physician and provider problems that need to be resolved during the transition.

CMS will authorize advanced payments if Medicare contractors are unable to process claims within established time limits due to problems with ICD-10 implementation.

So the question becomes, does ICD-10 become yet another straw designed to break the camel's back?

At our faculty meeting last week, representatives of the medical college and the hospital came to update us on the changes coming into effect with ICD-10.

The compliance officers went through the changes in regulations -- for inpatients and outpatients -- which we've all heard before, the changes in the rules, and how ICD-10 leads to greater specificity for billing. Almost to the point of ridiculousness.

MedPage Today

CMS Proposes Outpatient Payment Update A cut in outpatient payment rates as well as changes to conversion rates

WASHINGTON -- The Centers for Medicare and Medicaid Services released a plan for reimbursing hospitals and ambulatory surgical centers starting in 2016 on Wednesday. Proposed changes include a reduction in outpatient payment rates as well as updating Medicare's conversion rate in the physician payment schedule.

Under the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System, CMS proposed changes in payment rates for hospital outpatient departments (HOPDs), ASCs, and partial hospitalization services conducted in community mental health centers (CMHCs).

MedPage Today

Opinion: The Coming Shock in Health-Care Cost Increases

By upholding the legality of insurance subsidies on the federal exchange, the Supreme Court secured President Obama's legacy of expanding access to health care. Now Mr. Obama must secure the other fundamental legacy of the Affordable Care Act: controlling health-care costs.

The growth of health-care spending has slowed in recent years, and per-person Medicare and Medicaid costs have declined. Several factors contributed to this slowdown. The Great Recession threw workers off employer plans and left others with less money to spend on health care. A long-term trend of rising deductibles discouraged people from getting care. The patents of many high-cost drugs-such as Lipitor for high cholesterol-expired, increasing the use of lower-price generic drugs.

Wall Street Journal

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Study: Smokers, substance abusers more likely to get in trouble with painkillers

WASHINGTON - Researchers say the person most likely to develop problems with prescription opiod painkillers is someone with a history of substance abuse, including nicotine.

A team at the Mayo Clinic took a random sample of 279 patients who received new prescriptions in 2009 for an opioid painkiller like oxycodone or morphine.

Though their initial prescription was only for a few days, one in four progressed from short term use to prescriptions lasting three months or longer.

One in 4 Patients Prescribed Opioids Will Move to Long-Term Use

 Weighing the pros and cons of prescription opioid use for chronic pain is an ongoing battle, and new research may have just added to the list of disadvantages.

Nearly 25% of patients with an opioid prescription will end up using the drugs long-term. This finding comes on the heels of a recent study that revealed physicians do not understand the scope of the prescription pain medication problem in the US. Lead author W. Michael Hooten, MD, and colleagues from the Mayo Clinic explained how they made this discovery and what can be done to reduce the number of people on chronic opioid therapy. 

Click HERE to read study

Should There Be a Dress Code for Doctors?

If you live near a hospital, you've probably seen the sight: a young physician in loose blue scrubs, standing in line at the grocery store. You can't help but wonder if the young physician is lost. After all, it appears that he or she belongs in an emergency room - not the dairy section.

The oversized bottoms, dangling bright orange pajama knot, deep V-neck and beeper ensemble not only look out of place, but lead to a slew of thoughts. Is he coming from or going to a shift? Could her clothes carry some sort of hospital microbe? What detritus has the outfit picked up on public transit or in line at the ATM that will track back to an operating room or patient? Has the American trend toward casual attire gone too far?

EMPR.com

How This Young Doctor's Twist On Venture Capital Could Revolutionize Healthcare Innovation

Even though change is looming, the healthcare industry has been slow at adopting new technologies. It could take years for new paradigms to be accepted and doctors often resist shifts in daily routines.

Enter Dr. Dhaval Bhanusali, who has been quietly spearheading Health Digital - a growing health technology startup based out of New York and Tampa. "The growth of health tech companies have been both impressive and inspirational. The issue is that the vast majority of ideas are not being readily incorporated into everyday practice," said Bhanusali during an interview. "The sad truth is that there is an entire generation of physicians out there who don't have a website, have never logged onto Facebook, and probably have no idea telemedicine exists."

Forbes

Researchers find key mechanism that causes neuropathic pain

Scientists at the University of California, Davis, have identified a key mechanism in neuropathic pain. The discovery could eventually benefit millions of patients with chronic pain from trauma, diabetes, shingles, multiple sclerosis or other conditions that cause nerve damage.

A biological process called endoplasmic reticulum stress, or ER stress, is the significant driver of neuropathic pain, said lead researchers Bora Inceoglu of the UC Davis Department of Entomology and Nematology and UC Davis Comprehensive Cancer Center, and Ahmed Bettaieb, Department of Nutrition. The work is published July 6 in the journal Proceedings of the National Academy of Sciences.

"This is a fundamental discovery that opens new ways to control chronic pain," said co-author Bruce Hammock, distinguished professor at the UC Davis Department of Entomology and Nematology and the UC Davis Comprehensive Cancer Center.

Medical Press