Date of ICD-10 Switch Still Uncertain

medical-coders-groupCongress’s move to delay by at least a year the switch to ICD-10 has thrown a monkey wrench into the many providers’ plans for moving to the new coding system.

For starters, the legislation passed in the Senate Monday and signed into law Tuesday doesn’t nail down a definitive switch date from ICD-9, despite a mention of October 2015.

Section 212 of the Protecting Access to Medicare Act of 2014 (H.R. 4302) states the Department of Health and Human Services (HHS) “may not, prior to Oct. 1, 2015, adopt ICD-10 code sets,” meaning that it could be later than next fall. A final date is likely to come through the federal rule-making process.

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“We now have no date for ICD-10,” Robert Tennant, senior policy advisor with the Medical Group Management Association (MGMA) here, told MedPage Today in a phone interview Wednesday.

So for physician groups and hospitals who may have been preparing to start billing with ICD-10 codes later this year, their plans for implementation, training, and testing are now out of whack.

“I think everybody wants to know what the date is,” said Christine Armstrong, principal at Deloitte Consulting, in Los Angeles. “Once you know the date, you can plan for it.”

The delay in the move to ICD-10, which was set to occur Oct. 1, 2014, was pushed back this week in a 120-page bill that also stalled planned cuts in physicians’ Medicare payments under the program’s sustainable growth rate (SGR) payment formula.

The extra line in a bill didn’t come as a great surprise to the folks at MGMA, who had been lobbying Congress hard on the issue, Tennant said.

Lawmakers there were concerned about the issue given one recent MGMA survey found fewer than one in 10 practices had made “significant progress” in preparing for the switch to ICD-10.

“There was clearly growing interest on Capitol Hill on this,” Tennant said.

The American Health Information Management Association (AHIMA), which pushed hard against including the provision in the SGR bill, expects the date to be sooner rather than later because of the time and money already spent on the move.

The delay will cost between $1.1 billion and $1.6 billion, according to the Centers for Medicare and Medicaid Services, which gave those estimates in 2012 when the ICD-10 switch was delayed by a year to 2014. Organizations expect to spend an additional 10% to 30% because of the delay.

“They’re anticipating at least that much more for another year delay,” Sue Bowman, director of coding policy and compliance at AHIMA, told MedPage Today in a phone interview.

Those costs could be higher this time around, because organizations are further along in their ICD-10 transition.

Armstrong said providers will most likely not be able to submit ICD-10 codes later this year, even if they’re ready to make the switch. But those unprepared to make the jump to ICD-10 in October must feel like school kids who didn’t do their homework and then received an unexpected snow day.

Many organizations have spent considerable time and resources to prepare for ICD-10, Armstrong said. In that case, they must continue to implement training and testing — but do so at a slower pace. Stopping and restarting may be difficult because an organization will likely lose momentum.

Armstrong and other consultants, in a webinar Wednesday on the future of ICD-10, gave several suggestions for providers:

  • Take the opportunity to fully test systems and processes
  • Refocus work during the transition
  • Incorporate lessons learned from the delay announced by HHS in 2012
  • Expand collaboration with other organizations, vendors, and payers
  • Extend and specify training

Michelle Leavitt, director of courseware and product strategy at HealthcareSource, in Woburn, Mass., suggested giving coders and other office staff tests every month until implementation, since it’s unlikely they will remember all that they’ve learned over the next 18 months.

“This could be as simple as a short quiz each month or a case study where employees code the case in ICD-10,” Leavitt told MedPage Today in an email.

The jump straight from ICD-9 to ICD-11 — as some opponents of ICD-10 have suggested in the past — may not be likely.

ICD-11 won’t be released until 2017 and likely won’t be available in the U.S. until at least 2020, Jeff Smith, director of public policy at the College of Healthcare Information Management Executives in Ann Arbor, Mich., said.

“Waiting until 2021 or 2022 is simply not an option given the kind of payment reforms that are needed, and given the wholly inadequate nature of ICD-9 codes,” Smith told MedPage Today in an email.

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Originally published on: MedPageToday.com

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This Post Has One Comment

  1. Unfair to delay ICD 10

    My daughter has been going to college for years to get the certification for the ICD 10 – she has worked very hard for this and now one month before she will graduate, they pulled the rug from underneath her! She was hoping to get a great job. She’s a straight A student, single Mom, struggling to make ends meet. Now the school want to cram all the students learn ICD 9 in 5 weeks! Absurd!

    Please do not delay this from happening. It is not fair to everyone that has been studying so hard with everything they have to just pull it from them after ALL THIS time!! Please don’t just thinking about the doctors and hospitals, etc. This about the poor students that will be graduating next month and have nowhere to go to look for a job with coding since nobody will be using all the information they have learned. THIS IS ABSOLUTELY WRONG!

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