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HHS proposes one-year delay of ICD-10-CM/PCS

HCPRO Website, April 9, 2012

by Andrea Kraynak, CPC

HHS released a proposed rule today announcing a one-year delay of the implementation of ICD-10-CM/PCS. If finalized, ICD-10 would become effective October 1, 2014.

“Many provider groups have expressed serious concerns about their ability to meet the Oct. 1, 2013, compliance date. The proposed change in the compliance date for ICD-10 would give providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition to these new code sets,” according to an April 9 press release.

“This is what I expected,” says Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CPC-I, CCDS, director of HIM and coding at HCPro, Inc., in Danvers, Mass. “But I am happy to hear that they didn’t seem to consider bypassing ICD-10 and going right to ICD-11. This goes to show that they do see the value in the system.”

She believes this delay will give providers the necessary time to implement and handle the costs associated with the change. “And now that we know the deadline, there is no excuse,” she says. “At this point, we have a date in sight again and we shouldn’t waste away the time that we have. We were given the extra time; use it wisely.”

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 (OEID), as well as add a National Provider Identifier (NPI) 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.

Those in the healthcare industry offered mixed reactions to the proposed length of the delay.

“It is disheartening and encouraging in many respects. Disheartening for the facilities and practices who spent the money to prepare for the October 1, 2013 deadline but encouraging for those same people to be ahead of the game now as to breathe a little easier,” says James S. Kennedy, MD, CCS, managing director of FTI Consulting in Brentwood, Tenn.

“The best way to prepare for ICD-10 implementation continues [to be] to first practice ICD-9-CM correctly and then negotiate the differences in ICD-10” Kennedy says. This [proposal could] give us another year to get our infrastructure together and fill in the documentation and coding gaps so facilities can be ready to adapt to ICD-10.”

Meanwhile Cheryl Ericson, MS, RN, clinical documentation improvement education director for HCPro Inc, points out, “This gives everyone an opportunity to slow down, take a deep breath.”

“Most organizations should maintain their current course of progress so that coders become fluent in ICD-10. This just gives everyone extra time for improvement and gives us greater opportunities to recognize weaknesses in documentation,” she says.

She notes that the 2013 compliance deadline was going to be tight for most organizations, but the delay will give everyone time to consider dual coding prior to implementation. “Take this as a blessing in disguise. Train your staff members and get them comfortable so that when the transition does come, it won’t be as stressful,” Ericson says.

Rose T. Dunn, MBA, RHIA, CPA, FACHE, chief operating officer of First Class Solutions, Inc. in Maryland Heights, Mo., and former president, board member, and interim CEO of AHIMA, is disappointed that CMS is delaying a full year and would have preferred only a six-month postponement. “I’d continue to encourage providers to prepare for ICD-10 at a calmer pace and take advantage of spreading the cost of implementation over another year,” she says.

To comment on the proposed rule, visit www.regulations.gov. Comments are due within 30 days of publication in the Federal Register. The rule is due to publish in the April 17 edition of the Federal Register.

Editor’s note: For more information, view the related Fact Sheet. A display copy of the proposed rule is available online. The original announcement of a potential delay came earlier this year in a February 16 press release.

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