Could It Really Be True, ICD-10’s Go Live Could Be Put On Hold?

by Phil C. Solomon on March 26, 2014

in Hospital Legislation,Revenue Cycle Management

Following House’s lead, Senate introduces bill to repeal ICD-10

ICD-10… what a conundrum, right? Early last year, many of my colleagues had pontificated about the possibly of the ICD-10 transition would be pushed back. I was one of those who thought that “healthcare” had delayed roll outs for other pending legislation and there was no way they would delay ICD-10. Well I may have been wrong. Could it happen? It sure could. I’m going to sit back and enjoy the ride as developments unfold…. Here’s another idea, should we just forget about the ICD-10 mess and wait until 2017 for ICD-11?

I am still working with my client’s, who are planning ahead and beefing up their coding resources in anticipation of the potential catastrophic reduction in productivity which is on the way. With all of the ICD-10 talk, it’s got me thinking. This time in history is like riding a healthcare roller coaster. When you get off the ride, you’ll either be sick or act like you just had the thrill of your life. – PCS

ICD-10

A bill seeking repeal of the ICD-10 code set is now in both chambers of Congress after its introduction to the U.S. Senate last month.

The Cutting Costly Codes Act of 2013External Link, which was first introduced into the U.S. House of Representatives in April, would prohibit the U.S. Department of Health and Human Services from implementing, administering or enforcing current regulations that require the new code set to take effect Oct. 1, 2014. The bill was introduced to the Senate May 16 by Senators Tom Coburn, MD, R-Okla., John Barrasso, MD, R-Wyo., Rand Paul MD, R-Ky., and John Boozman, R-Ark.

In addition to repealing implementation of the ICD-10 code set, the legislation also would require a federal study on ways to mitigate the disruption any replacement of the ICD-9 code set would cause for physicians and other health care providers.

The AMA has voiced strong support for the legislation, including a formal letterPDF FIle sent to Rep. Ted Poe, R-Texas, the day he submitted the bill to the House.

“The differences between ICD-9 and ICD-10 are substantial, and physicians are overwhelmed with the prospect of the tremendous administrative and financial burdens of transitioning to the ICD-10 diagnosis code set with its 68,000 codes—a five-fold increase from the approximately 13,000 diagnosis codes currently in ICD-10,” the letter states.

Experts say the new code set will affect not only claims submissions but also such processes as patient eligibility verification, pre-authorization for services, documentation of patient visits, research activities, and public health and quality reporting. The cost for individual physician practices to adopt ICD-10 is estimated to be around $83,000 for a small practice and as much as $2.7 million for a large group practice.

At the same time, physicians should make preparations for the new code set to avoid disastrous results if ICD-10 is rolled out as planned. Those who aren’t ready by next year’s deadline will not receive payment for their services. Resources to help physicians prepare are available on the AMA’s ICD-10 Web page and through the AMA StoreExternal Link.

The AMA will continue to work with members of Congress toward a solution to ensure physicians’ practices are not disrupted as the result of implementation of a new code set.

This post can be seen on the AMA website

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Phil C. Solomon is a healthcare finance, clinical documentation and revenue cycle BPO strategist with experience spanning two decades. Phil has expertise in the areas of revenue cycle optimization, clinical documentation improvement, healthcare technology integration and BPO outsourcing. He is the publisher of Revenue Cycle News, a healthcare revenue cycle blog and is a featured speaker at many HFMANAHAM and AAHAM healthcare educational conferences.

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