by Minnette Terlep, BS, RHIT
Posted on: January 7, 2015
As 2014 came to a close, ICD-10 proponents found themselves holding their breath as efforts ramped up yet again to delay the transition date. In this case, opponents including state medical associations and the National Physicians’ Council for Healthcare Policy (NPCHP) sought a two-year delay, pushing for its inclusion in “must pass” legislation.
In a letter to House Speaker John Boehner, NCPHP and the medical societies wrote that a delay was necessary “to allow for physicians to work thru the myriad of new government regulations that face us. The costs of the new ICD-10 coding and billing mandates scheduled for October of 2015 will force financial disruptions and chaos. Patients will lose their doctors!”
Proponents were equally adamant that the 2015 date remain in place. In their own letter to Boehner, that the Coalition for ICD-10, a group made up of 15 organizations including CHIME, AHIMA, AHIP and the HFMA, made the case that delays have already caused more damage than good.
The group wrote: “ICD-10 implementation delays have been disruptive and costly for all of the coalition members, as well as to health care delivery innovation, payment reform, public health, and health care spending. As you know, significant investments were made by members of our coalition to prepare for the October 2014 implementation prior to enactment of the most recent delay. Many of us had to quickly reconfigure systems and processes that were prepared to use ICD-10 back to ICD-9. Newly trained coders who graduated from ICD-10 focused programs were unprepared to find jobs using the older code set.”
Ultimately, Congress adjourned without any action on the ICD-10 front. Reps. Pete Sessions and Fred Upton, chairs of the House Energy & Commerce and Rules Committees, declined to add an amendment to the omnibus federal spending bill. They did, however, pledge to examine the state of ICD-10 preparedness.
In a joint statement, they wrote: “As we look ahead to the implementation date of ICD-10 on October 1, 2015, we will continue our close communication with the Centers for Medicare and Medicaid Services to ensure that the deadline can successfully be met by stakeholders. This is an important milestone in the future of health care technologies, and it is essential that we understand the state of preparedness at CMS. Following the most recent delay of ICD-10, we heard from a number of interested parties concerned about falling behind or halting progress. We would like to acknowledge and thank these organizations and individuals for opening up this dialogue and expressing their thoughts and concerns regarding this issue. It is our priority to ensure that we continue to move forward in health care technology and do so in a way that addresses the concerns of all those affected and ensure that the system works.”
Thus, while the issue of a delay is tabled, it is by no means dead.
But hospitals and healthcare organizations should not use the uncertainty surrounding ICD-10 as an excuse to push pause on transition plans. As it stands, all healthcare organizations must be ready to submit claims under ICD-10 on Oct. 1, 2015. Those that aren’t ready, will take an immediate and significant hit to the bottom line, as CMS has indicated they will reject outright any claims submitted in ICD-9 as of that date.
It’s not just the financial impact that should drive hospitals to finalize their transition. The expansive code set will enable better documentation of patient encounters—key data that can be used for improved care, better research and more comprehensive population health planning.
In particular, coders should be undergoing extensive ICD-10 training or gaining on-the-job practice through dual-coding programs. This will also help identify areas of weakness in both processes and training, and reveal potential financial minefields requiring attention now while there is still time to correct them.
By ignoring the rumors and pushing forward with transition plans, savvy hospitals and healthcare organizations are taking charge of their future.
Minnette Terlep, BS, RHIT, is vice president of business development and chief compliance officer for Amphion Medical Solutions. She can be reached at Minnette.Terlep@amphionmedical.com.
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