Yesterday, March 31, 2014, the senate passed a bill to delay ICD-10 implementation until 10/1/2015. By a vote of 64 to 35, the Senate voted to delay ICD-10 by at least one year. The bill is being sent to President Obama where his signature is expected.
This bill includes a suspension of Medicare’s Sustainable Growth Rate (SGR) formula, delaying a 24% cut in physician reimbursement, and delays the Medicare “two midnight” payment policy for hospitals until March of next year. This was the original content of the bill, it is not clear how or when the ICD-10 delay later became part of this bill.
While the delay in implementing the new ICD-10 code sets helps organizations that were struggling to meet the 10/1/14 deadline, many organizations feel that this legislation is a big step backwards. The bill actually states that the Department of Health and Human Services cannot adopt the ICD-10 code set until at least 10/1/15, allowing for possible further delays.
CHIME (College of Healthcare Information Management Executives) objected to this delay in an article on their web site:
Their position is that this delay will increase the costs of providers who invested early in the training of their staff regarding new procedures and workflows related to the new code set. Once again, these training schedules will need to be pushed back and those who have already invested in training and software, will have to reinvest again when the new deadline approaches. Just a couple of weeks ago, on 3/12/14, administrator Marilyn Tavenner of CMS published a letter reaffirming their support of the 10/1/2014 deadline for ICD-10:
In this letter, she states:
“We have already delayed the adoption standard, a standard the rest of the world has adopted many years ago, and we have delayed it several times, most recently last year. There will be no change in the deadline for ICD-10.
ICD-10 is the next generation coding system that will modernize and expand the capacity of public and private payers to keep pace with changes in medical practice and healthcare delivery. Thus, ICD-10 will provide higher quality information for measuring service quality, outcomes, safety, and efficiency.
Moreover, any further delays in adoption of ICD-10 in the U.S. will make it difficult to track new and emerging public health threats. The transition to ICD-10 is time-sensitive because of the urgent need to keep up with tracking, identifying, and analyzing new medical services and treatments available to patients. Continued reliance on the increasingly outdated and insufficient ICD-9 coding system is not an option when considering the risk to public health.”
This extension of ICD-10 delays all the advantages associated with the implementation of this more detailed and accurate coding system. Many organizations are already voicing their displeasure with this last minute legislation including the CHIME, MGMA, and AHIMA. Furthermore, these continual and repetitive delays in the implementation of this code set threaten the future credibility of new deadlines for implementation. With many months of preparation required to switch from ICD-9 to ICD-10, it is very difficult for all the players to know when to invest in new training, software, and procedures.
By Kalon Mitchell – President, MEDTranDirect