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Meaningful Use Readiness

AMA Statement on Proposed Rule Regarding Meaningful Use

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Statement attributed to:
Steven J. Stack, MD

Immediate Past Chairman of the Board of Trustees, American Medical Association

“The American Medical Association (AMA) appreciates the changes proposed by the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) yesterday to make it easier for physicians to achieve Meaningful Use. However, our chief concern remains unaddressed and we worry that current requirements will slow the adoption of technology that will help coordinate care and improve quality and that many physicians will drop out of the Meaningful Use program if the current all-or-nothing approach remains in place. To date approximately twenty percent of eligible professionals – mostly doctors – have dropped out of the program and we expect this number to grow unless more changes are made.

“A recent RAND Health reportExternal Link commissioned by the AMA reflects physician dissatisfaction with the Meaningful Use program and accounts for some of the reasons many are dropping out. It found that physicians feel the Meaningful Use program is burdensome and, in many cases, doing nothing to advance patient care. Allowing physicians who are having difficulty updating software to use electronic health records that have been certified for the 2011 Edition for 2014 and giving them an additional year to achieve Stage 2, could help more physicians meet the program requirements and avoid a financial penalty in 2015. Although those proposed changes are helpful, we believe the current requirements, particularly for Stage 2, still remain a longshot for many doctors to meet.

“We recommend that CMS and ONC replace their all-or-nothing approach with a 75 percent pass rate for achieving Meaningful Use. Additionally, we believe that physicians who meet at least 50 percent of the Meaningful Use requirements be able to avoid financial penalties. Absent this type of flexibility, we are concerned that the Meaningful Use program may falter irreparably.

“We also recommend that CMS better align quality reporting programs. The rule proposed yesterday does not adequately address reporting clinical quality measures because physicians still must report separately for Physician Quality Reporting System (PQRS), Value Based Modifier (VBM) and Meaningful Use programs to avoid penalties and receive incentives. That inefficiency places an additional burden on physician practices that does not improve care.”

CMS News

How Will ICD-10 Affect Clinical Documentation?

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As practices prepare for the October 1, 2014, transition to ICD-10, there’s been a good deal of discussion about the many new codes ICD-10 offers and how clinical documentation will be affected. Just as with ICD-9, complete documentation is essential for patient care and accurate selection of ICD-10 codes.

ICD-10 Captures Familiar Clinical Concepts

Concepts that are new to ICD-10 are not new to clinicians, who are already documenting a patient’s chart with more clinical information than an ICD-9 code can capture about:

  • Initial Encounter, Subsequent Encounter, or Sequelae
  • Acute or Chronic
  • Right or Left
  • Normal Healing, Delayed Healing, Nonunion, or Malunion

Many ICD-10 codes—more than one-third—are identical except for indicating laterality, or whether the right or left side of the body is affected. The advantage of ICD-10 codes is that they enable clinicians to capture laterality and other concepts in a standardized way that supports data exchange and interoperability for a more efficient health care system.

Verifying Your Documentation Is ICD-10-Ready

While ICD-10 should not require providers to change documentation practices, reviewing documentation will help you understand how ICD-10 will affect your practice. Understanding the scope of the ICD-10 transition will reduce the likelihood that you will overlook areas that need updates for ICD-10. Testing ICD­ 10, from documentation all the way through communication with billing services, is vital to making sure you have worked out any snags in the process before the October 1, 2014, transition date.
Take a look at documentation for the most often-used ICD-9 codes in your practice and work with coding staff to select the appropriate corresponding ICD-10 codes. Identifying these codes will help reinforce the information to highlight when documenting patient diagnoses for ICD-10.

Keep Up to Date on ICD-10

Visit the CMS ICD-10 website for the latest news and resources to help you
prepare for the October 1, 2014, deadline.