Thursday, March 27, 2014

Possible ICD-10 Implementation Delay

 Possible ICD-10 Implementation Delay

Recently, there has been a stir amongst the medical community regarding the implementation of ICD-10.

This is not the first time ICD-10 has caused a stir. The United States Department of Health and Human Services (HHS) has already pushed back ICD-10 implementation once before, and H.R. bill 1701 (Cutting Costly Codes Act of 2013) is still up for vote as it was passed onto the House Subcommittee on Health and the Senate Committee on Health, Education, Labor and Pensions in April and May of 2013, respectively. According to the American Academy of Family Physicians, Dr. Jeff Cain wrote to Secretary Kathleen Sebelius in February requesting that she reconsider the deadline for implementation of ICD-10.

Cain’s concerns were as follows:
  • Lack of appropriate education - As of February 2014, 79% of providers are not ready or haven’t begun implementation yet according to MGMA
  • Expense to implement (costs between $56,639 and $226,105 according to AMA)
  • Lack of adequate end-to-end testing
  • Multiple health plans and payers is causing more expense and challenge across the country
  • CMS has only focused on testing and training within hospitals and large health system, not small or medium sized practices
  • Implementation will interrupt cash flow, putting small and medium sized practices out of business
    • This includes rural and underserved patients

Suggestions made by Cain to Sebelius include:
  • Increasing CMS funding to create more educational resources for smaller practices
  • CMS should require end-to-end readiness testing each month for one week until July 2014
    • Results should be made public and show effectiveness of the system
    • If results are not positive, delay ICD-10 implementation for at least one more year
  • Provide funds to Medicare contractors for education on the use of ICD-10 codes

Although CMS Administrator Marilyn Tavenner, M.A., has already confirmed the deadline will remain intact, legislation to patch the sustainable growth rate (SGR) for another year could potentially delay ICD-10 implementation until October 1, 2015. Currently, the 121-page bill has been crafted for vote March 27, 2014 (today) by Congress, which would also extend the current SGR fix until March 31, 2015. This extension could prevent reduced Medicare payments (24%) to providers in addition to delaying the ICD-10 implementation.

Wherever you are in learning about ICD-10, you should know that it is imperative to keep on chugging along and never count on further delays. It’s always best to be prepared for anything when it comes to your patients care and for your own sake, your own revenue! CMS has released a document containing resources to aid those having trouble with ICD-10 implementation. 

As an update --- As of April 1, 2014 --- The Senate passed the bill delaying the implementation of ICD-10 for one year until 2015! 



  1. This has been implemented so may want to update. Thanks for the info!

    1. Thanks! I need to update quite a few articles and now that my PANCE and PA school are complete - hopefully I'll have the time!


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