AMA: No smooth sailing for docs on 5010

Posted: February 9, 2012 - 11:15 am ET

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The American Medical Association is pulling up just short of an outright call for a second extension to an enforcement deadline for adoption of ASC X12 Version 5010 standards for transmission of electronic claims and other administrative transactions.

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In an e-mailed statement, AMA President Dr. Peter Carmel said that in the month since the 5010 standard were implemented, "physicians are experiencing very alarming problems that have resulted in significant interruptions in claims processing and cash flow." He added: "It's clear that the problems will not be solved overnight."

Last week, citing feedback from its members, the MGMA-ACMPE, formerly the Medical Group Management Association, called for a second 90-day delay of the start date for enforcing a federal requirement that covered entities abandon the Version 4010 standards and switch to 5010 by Jan. 1, 2012.

In November, HHS pushed back enforcement until the end of March while leaving in place the Jan. 1 compliance deadline.

Carmel said in his e-mail that the AMA "fully expects that another extension to the 5010 enforcement deadline will be needed to resolve the emerging issues." The AMA is considering recommendations for a specific timeline for an enforcement delay, but enforcement shouldn't begin in any case, Carmel added, until the "vast majority of physicians" are seen to be receiving timely payments under the 5010 standard.

"These problems are particularly troubling since cash-strapped physicians are burdened with meeting several other government requirements, including quality reporting, e-prescribing, meaningful use and of course, ICD-10," said Carmel, referring to the International Classification of Diseases 10th Revision family of diagnostic and procedural codes.

Conversion to 5010 is considered a necessary precursor to adoption of the ICD-10 codes sets. ICD-10 is mandated for use by Oct. 1, 2013.

But also last week, Dr. James Madara, the AMA's executive vice president and CEO, appealed to HHS Secretary Kathleen Sebelius to halt the planned ICD-10 conversion.