Industry Stakeholders Call on CMS for Guidance on ICD-10 Delay

April 2, 2014 in News

Health IT experts and industry stakeholders are looking to CMS to provide clarity on a newly enacted law that delays the ICD-10 compliance deadline until at least 2015, Modern Healthcare reports (Carlson/Robeznieks, Modern Healthcare, 4/1).

Background on ICD-10

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch means that health care providers and insurers will have to change out about 14,000 codes for about 69,000 codes.

In August 2012, HHS released a final rule that officially delayed the ICD-10 compliance date from Oct. 1, 2013, to Oct. 1, 2014, partially to look at the incremental changes needed in reforming health care (iHealthBeat, 4/1).

Delay of ICD-10 Compliance Deadline

On Tuesday, President Obama signed into law “doc fix” legislation (HR 4302) to delay scheduled cuts to Medicare physician reimbursement rates (Modern Healthcare, 4/1).

The law, introduced by Rep. Joseph Pitts (R-Pa.), includes a provision that pushes back the ICD-10 compliance date until at least October 2015.

The measure states, “The Secretary of Health and Human Service may not, prior to Oct. 1, 2015, adopt ICD-10 code sets as the standard for codes sets.” It also cites sections in the Social Security Act and the Code of Federal Regulations that contain the secretary’s authority to mandate the new code sets.

CMS estimates that a one-year delay of ICD-10 could cost between $1 billion and $6.6 billion, according to a blog post by the American Health Information Management Association, which opposes the delay (iHealthBeat, 4/1).

Many Questions Remain

The health care industry is divided over the ICD-10 compliance deadline delay, but most stakeholders agree that CMS needs to provide more clarity about the new law.

Workgroup for Electronic Data Interchange President and CEO Devin Jopp said, “We do need some guidance from CMS to make some decisions. For example, training. What should we do with training now?”

According to Modern Healthcare, CMS could help stakeholders determine:

  • If Oct. 1, 2015, will become the new deadline;
  • If CMS will grant voluntary ICD-10 implementation to those that are ready; and
  • If the agency is considering skipping ICD-10 and instead implementing ICD-11, which is scheduled to be released in 2017 (Modern Healthcare, 4/1).
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