Physician Practice

SGR reform passes with no ICD-10 delay, so what's next?

Physician Practice Insider, April 21, 2015

Congress finally repealed the Sustainable Growth Rate (SGR) this month. The fix ends more than a decade of threats of massive cuts to physician Medicare payments followed by last-minute patches stuffed with potentially unexpected and controversial healthcare riders.

Last year, the SGR patch bill included an ICD-10 delay just six months before implementation. Despite providers being at various stages of readiness last year before the delay, many still preferred the certainty of the October 1, 2014 deadline over the meddling of Congress in ICD-10 matters.

Congress finally seemed to get that message this year when providers overwhelmingly supported the new October 1, 2015 implementation date during a House subcommittee hearing. They included no delay language in this year's SGR repeal bill.

At this year's AAPC HealthCon, HCPro spoke with several coders and coding department managers who were frustrated with the repeated delays and just wanted someone to tell them whether ICD-10 was officially coming so they could train physicians confidently and move forward with testing. Indeed, the repeated delays appear to be the biggest detriment to progress for many providers.

Unfortunately, no one at CMS is likely to make such a pronouncement at this point, considering the agency did so just a few weeks before last year's delay. However, with less than six months to go before implementation, ICD-10 implementation is now more likely than ever. Each previous delay came at least six months before implementation, and with no threat of a last-minute SGR patch again, Congress is unlikely to attempt to pass new legislation related to ICD-10.

So what's the next step for providers now that their greatest roadblock to implementation has been removed? Hopefully coding departments have already been trained and continue to practice ICD-10 coding. Even if facilities are not part of CMS' end-to-end testing process, CMS is conducting continuing acknowledgement testing, with designated weeks that include additional contractor customer support.

It's also time to let physicians know that ICD-10 is truly coming and prepare them by focusing on the specific concepts they need to know so coders can choose the most specific ICD-10 codes.

Providers have many details to consider now, but after repeated reprieves, they have no excuse for not being as prepared as possible when October 1, 2015, arrives.

This article originally appeared in APCs Insider.

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