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Congress votes to delay ICD 10 CM PCS

Congress votes to delay ICD-10-CM/PCS until at least Oct. 1, 2015

Now with the extra time to prepare, stay the course with your ICD-10-CM/PCS transition action plan

Congress has passed and the President has signed into law a bill that delays the implementation of ICD-10-CM/PCS by at least a year.  The Protecting Access to Medicare Act of 2014 extends the current Medicare?s Sustainable Growth Rate (SGR) to April 15th, 2015 by putting on hold the scheduled 24% cut to Medicare physician payments with other provisions that would delay other Medicare deadlines as well. The bill also contains a provision to delay the implementation of ICD-10-CM/PCS by at least a year. This bill injects additional uncertainty in the health care industry regarding the timeline of the nationwide code set conversion along with the uncertainties of the Affordable Care Act (ACA).

The switch to ICD-10-CM/ PCS was scheduled to occur Oct. 1, 2014 . But under the new Protecting Access to Medicare Act of 2014, the Secretary of Health and Human Services is prohibited from adopting the ICD-10-CM/ PCS code set until Oct. 1, 2015 . The new code set would modernize and expand the capacity of public and private payers to keep pace with change in health care, and provide higher quality information for measuring quality, outcomes, safety and efficiency. The health care industry has already made significant investments in the ICD-10-CM/ PCS transition, and further delays would require ICD-9-CM versions of systems to be updated to remain current. The extent of the logistical challenges and costs associated with ?dialing back? to ICD-9-CM are not yet fully understood, The American Health Information Management Association (AHIMA) officials said, but are ?expected to be extensive.?

This delay in implementation of ICD-10-CM/ PCS injects uncertainty in the health care industry about the timeline of the nationwide conversion. The healthcare industry has poured resources and funding into their implementation readiness plans over the last few years. CMS estimates that a one year delay could cost between $1 billion to $6.6 billion, according a statement from AHIMA officials. ?This is approximately 10-30 percent of what has already been invested by providers, payers, vendors and academic programs,? AHIMA wrote in a statement.

AHIMA said in a news release Monday it is deeply disappointed with yet another ICD-10 delay, and is committed to seeking immediate clarification on technical issues such as the exact length of the delay. The American Medical Association, which has lobbied against the ICD-10-CM/ PCS code set for more than a decade, was not supportive of legislative action since it did provide a long-term solution to the SGR issue. However, the insertion of the ICD-10-CM/ PCS delay provision was done to placate physicians who are against an SGR patch. The AMA has said they are against moving to ICD-10 entirely.

With ICD-10 implementation delayed, organizations are asking themselves the question, ?Now what??

While the congressionally mandated delay in the switch to ICD-10-CM/ PCS will have a profound impact on the health care industry, it?s important for organizations to stay their course. ICD-10-CM/ PCS will still happen, which means planning, testing and implementation activities should continue. By phasing in specific activities, payers and providers will be thoroughly equipped for the transition and to achieve potential benefits. 

Aggressive preparation for ICD-10-CM/ PCS should include working with software and systems vendors to ensure all systems are fully compliant, and engaging in staff training well in advance to help mitigate any loss of productivity or revenue. 

The transition to ICD-10-CM/ PCS remains inevitable and time-sensitive because of the potential risk to public health and the need to track, identify and analyze new clinical services and treatments available for patients, AHIMA said. The organization will continue to help lend technical assistance and training to stakeholders as they are forced to navigate the challenge of continuing to prepare for ICD-10-CM/ PCS while still using ICD-9-CM.

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