Coalition Slams Two ICD-10 ‘Safe Harbor’ Bills in House

June 17, 2015 in News

This week, the Coalition for ICD-10 in a public statement criticized two House bills that would create a “safe harbor” for physicians as they begin using the new ICD-10 coding sets, Health IT Analytics reports (Bresnick, Health IT Analytics, 6/16).

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 by Oct. 1

Details of the Bills

The Protecting Patients and Physicians Against Coding Act of 2015 (HR 2652) would create a two-year grace period during which providers would not be denied Medicare or Medicaid payments because of coding errors when submitting claims. In addition, the bill would require a study be conducted that examines how the coding transition has affected the health care industry, particularly providers located in rural areas (iHealthBeat, 6/10).

The Transitioning Effectively Now — or ICD-TEN — Act (HR 2247), would implement a transition period following the implementation of new ICD-10 code sets. In addition, the bill would require HHS to conduct 18 months of testing to ensure that the Medicare fee-for-service claims processing system works effectively with the ICD-10 codes. If Congress were to determine that ICD-10 implementation was not “functional” at that time, the bill would direct HHS to develop additional measures to improve the code set’s functionality (iHealthBeat, 5/14).

ICD-10 Statement

In a statement, the Coalition for ICD-10 argued that ICD-10 diagnosis codes do not directly affect physician payments, which are determined by CPT codes (Miliard, Healthcare IT News, 6/16). 

The coalition also wrote that the new code sets will not be burdensome to physicians as “no physician will use all of the ICD-10 codes, but will only use the subset of codes applicable to his/her specialty and patient population” (Coalition for ICD-10 statement, 8/14).

In addition, the group outlined six reasons why the bills would have “far-reaching, negative consequences” for the health care system” (Healthcare IT News, 6/16). It said the legislation would:

  1. Undermine Medicare’s ability to determine coverage, medical necessity and quality of care;
  2. Prevent Medicare from ensuring proper payment;
  3. Raise concerns about fraud and abuse;
  4. Allow providers to bypass complete documentation;
  5. Cause widespread system disruptions; and
  6. Amount to just another ICD-10 delay (Walsh, Clinical Innovation Technology, 6/15).
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