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.