Health Information Management

CMS' new ICD-10 date likely to disappoint providers--whenever it’s announced

APCs Insider, April 11, 2014

Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

 

In the nearly two weeks since the government introduced, voted on, and signed into law a bill that included an ICD-10 implementation delay, CMS has remained silent.
 
In fact, CMS still hasn't updated its ICD-10 landing page to note that implementation will be delayed until at least October 1, 2015. Perhaps this is part of the wishful thinking prevalent in the provider community to stick with the 2014 implementation date.
 
An overwhelming 57% of the 162 respondents to last week's poll asking when ICD-10 should be implemented chose October 1, 2014. Meanwhile, 26% suggested waiting until ICD-11, with 15% hoping for October 1, 2015.
 
An open poll at JustCoding.com of approximately 80 respondents has roughly similar results, with 43% wishing for the 2014 date to be reinstated, 32% wanting to wait until ICD-11, and 20% hoping for a 2015 implementation.
 
Unfortunately, it's unlikely providers and coders will get the result they want. Congress will not likely pass legislation to restore the 2014 implementation date, according to AHIMA’s Margarita Valdez, director of congressional relations, in a recent webcast.
 
Despite the fact that providers have spent billions on training, staff, technology, and software to prepare for ICD-10—and the delay will likely cost them billions more—this makes sense for a variety of reasons.
Members of Congress never mentioned the delay during the bill's debate, since it was primarily about preventing a 24% cut in physician Medicare reimbursement.
 
Many members of Congress will be busy campaigning for November's midterm elections, further slowing the pace of a historically unproductive group of legislators. And considering the most-watched cable news channel already tried to link ICD-10 to Obamacare, there's little reason to expect public or bipartisan support for an ICD-10 deadline reinstatement, as healthcare is a contentious issue for the midterms.
 
The second most popular poll choice, waiting for ICD-11, is also unlikely. It will not be available until at least 2017, after suffering its own delays. The four Cooperating Parties will then need to modify it to suit the coding and billing requirements of the U.S., which could take years. This means it would be well after 2020 that the industry would be ready to start using ICD-11. After all, other countries began using ICD-10 in 1994.
 
With ICD-9-CM already out of room for new diagnoses and the code set frozen, this would be an interminable amount of time to wait for a new system.
 
This leaves October 1, 2015—one of the least desired options—as the most likely. However, until CMS makes this certain, providers are left in complete limbo regarding training or technology upgrade timelines, as well as staffing issues.
 
Even though CMS' word can't be taken as immutable in light of the latest delay, and it needs to make sure the next implementation date is certain, right now its silence is even worse for the healthcare industry.

 



Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

    Briefings on APCs
  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular