Health Information Management

Healthcare News: HHS proposes one-year delay of ICD-10-CM/PCS, code freeze stands

JustCoding News: Inpatient, April 25, 2012

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HHS’ proposed rule announcing a one-year delay of the implementation of ICD-10-CM/PCS was printed in the April 17 edition of the Federal Register. If HHS finalizes the delay, ICD-10-CM/PCS would become effective October 1, 2014.

A one-year delay in ICD-10-CM/PCS isn’t a slam dunk. “We’re recommending it, but it’s not [guaranteed],” said Denise Buenning, group director CMS Office of E-Health Standards and Services. Buenning delivered CMS ICD-10 Report on State of the Union at the AHIMA ICD-10 Summit April 17 in Baltimore.

“The absolute worst thing you can do is stop working toward implementation,” Buenning added.

To comment on the proposed rule, visit Comments are due within 30 days of publication in the Federal Register. CMS offered up a 30-day comment period “because we want to put out the final rule as soon as possible,” Buenning said. Normally, HHS provides a comment period of 60 days or more. “We take feedback very seriously,” she said. “Positive and negative, we need all of it.”

The proposed rule, “Administrative Simplification: Adoption of a Standard for a Unique Health Plan
Identifier; Addition to the National Provider Identifier Requirements; and a Change to the Compliance Date for ICD-10-CM and ICD-10-PCS Medical Data Code Sets” also proposes the adoption of a unique health plan identifier under HIPAA. That proposal would implement several administrative simplification provisions of the Affordable Care Act and save an estimated $4.6 billion over 10 years for healthcare plans and providers. The proposed rule also includes the adoption of a data element that would serve as an “other entity” identifier , as well as add a National Provider Identifier  requirement.

The proposed rule explains that three main issues emerged in recent months regarding the previous October 1, 2013 compliance date, leading HHS to reconsider the deadline:

  • The transition to Version 5010 did not go as effectively as expected
  • Providers were concerned about a lack of resources due to competing statutory initiatives
  • Several surveys and polls showed a lack of readiness for the transition

“While we considered a number of alternatives for the delay…we believe a 1-year delay would provide sufficient time for small providers and small hospitals to become ICD-10 compliant and would be the least financially burdensome to those who had planned to be compliant on October 1, 2013,” the proposed rule states, estimating that a one-year delay would add an estimated 10%-30% to the total cost of implementation for those entities that have already spent or budgeted for the transition.

“Use any additional time to your best advantage,” Buenning said, adding “I’m sure testing will be a big part of that conversation.”
Code freeze concerns

Questions have emerged regarding the current ICD-9-CM code freeze since the announcement of the ICD-10 implementation delay. CMS confirmed that the code freeze will hold until ICD-10-CM/PCS is implemented regardless of the delay, according to Pat Brooks, RHIA, senior technical advisor at CMS. Brooks provided the update during the AHIMA ICD-10 Summit.
Brooks indicated CMS believed that doing away with the code freeze “would be rather catastrophic,” both for CMS and for providers.
This means the next regular code update won’t occur until one year after the eventual implementation of ICD-10-CM/PCS. If HHS finalizes the proposed October 1, 2014 implementation deadline, the next update would be October 1, 2015. The 2013 code updates will only relate to new diseases and technologies.

Editor’s note: For the latest news on the ICD-10 implementation delay, visit the ICD-10 Trainer blog.

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