Health Information Management

Another House ICD-10 ’fix’ is in

HIM-HIPAA Insider, July 27, 2015

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CMS and the American Medical Association (AMA) may have made peace regarding ICD-10, but it seems some members of Congress didn’t get the memo.

Reps. Marsha Blackburn (R-Tenn.) and Tom E. Price, R-N.C., introduced H.R. 3018, the Code-FLEX Act, July 10 to allow submission of ICD-9-CM and ICD-10-CM codes for 180 days after implementation.

It’s hard to believe another six months would be a panacea for providers who aren’t quite ready to implement ICD-10. ICD-10 has been delayed multiple times, giving providers sufficient time to prepare for the transition.

The idea behind dual coding after the transition isn’t new—and the same arguments against them still exist. At the February House Energy and Commerce Committee’s subcommittee on healthcare hearing on ICD-10, Carmella Bocchino, representing America’s Health Insurance Plans, testified that running dual systems would be both costly and confusing.

It’s easy to understand why. This would force payers to maintain two different systems and National Coverage Determinations would have to be maintained for both ICD-9-CM and ICD-10-CM. And what kind of a nightmare would that be for tracking episodes of care or other information if a patient sees a primary care provider (PCP) who reports in ICD-9-CM, then sees a specialist reporting in ICD-10-CM, then returns to the PCP?

It’s also hard to tell if the bill is only intended for physician practices. It doesn’t specify, referring to all healthcare claims processed by public and private payers. It wouldn’t be the first time Congress missed such a detail. The same vagaries cropped up in its last ICD-10 bill.

This bill will most likely fail to even make it out of committee, just like every other ICD-10 bill representatives introduced this year. With CMS and the AMA already issuing a joint statement that appears to signal a détente, it’s unlikely the agency will incorporate any type of dual coding before implementation.

This article originally appeared on HCPro’s ICD-10 Trainer blog.

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