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