I recently pointed out that the Republicans killed a recent attempt to repeal the Sustainable Growth Rate formula by attaching a measure to end the individual mandate in the Affordable Care Act. With failing to repeal the Sustainable Growth Rate it becomes necessary for Congress to pass yet another temporary “doc fix” to prevent Medicare reimbursement from automatically falling so low that doctors will not be able to afford to see Medicare patients.

Medical Economics reports that a proposal to delay the transition from ICD-9 to ICD-10 diagnoses codes from October 2013 to October 2014. The transition was originally passed under the Bush administration, so ignore the Republican claims which are out there which blame Obamacare for the change. While there are benefits to the newer system which is used by the rest of the world, the change would be very expensive for medical practices. Changes such as this also take up a lot of physician time, reducing the number of patients which can be seen each day.

Such decreases in productivity would come at a poor time in 2013 when millions of new people will receive health insurance due to the Affordable Care Act and will need to find physicians who are accepting new patients. In addition, the second phase of requirements for electronic medical records (EMR’s) also kicks in for many physicians this October and having two sets of major changes will further reduce physician productivity, making it more difficult to accept new patients. Personally I had to greatly restrict accepting new patients for several months after the first phase of requirements went into effect, and anticipate again having to limit accepting new patients this fall if both the new EMR requirements and change to ICD-10 take effect simultaneously.

The AMA and many other physician groups have been lobbying for a further delay in ICD-10 implementation, which has already been delayed in the past. Medical Economics reports:

The ICD-10 transition has been a major point of concern for physicians due to its scope and cost to implement. In recent months the American Medical Association (AMA) ramped up opposition to the ICD-10 transition, and petitioned CMS for a delay to the implementation of ICD-10.

According to the AMA, small practices can expect staggering costs ranging from $56,639 to $226,105 to implement the new code set. According to a February survey by the Medical Management Group Association, 79% of physicians report that they haven’t begun ICD-10 implementation, or were only “somewhat ready.”

Molly Cooke, MD, FACP, president of the American College of Physicians, said the college favors the delay. “The college has expressed concern at every opportunity about the implementation of ICD-10. I’m not sure the healthcare system loses a lot if we delay implementation for another year, and it certainly would give our members a bit of a breather.”Earlier this month, the Republican-led House passed a bill to repeal SGR and replace it with a formula that would calculate payments based on quality metrics. But the bill received widespread opposition from Democrats because it was paid for by a five-year delay in the individual mandate in the Affordable Care Act (ACA).