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Industry Fears Another ICD-10 Delay

By: Nextech | March 19th, 2015

Industry Fears Another ICD-10 Delay Blog Feature
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Yet Most Support the October 1, 2015 Deadline and Urge Not to Delay

Many health care professionals have been rushing to get prepared for the ICD-10 deadline, which is set for Oct. 1, 2015. The Centers for Medicare and Medicare Services set this deadline in May 2014, giving providers about a year and a half to make their systems compliant with ICD-10 software in time for the big switch.

This was the earliest possible implementation date allowed by the Protecting Access to Medicare Act of 2014, but it was still an extension of the initial deadline set for October 2014. The date was pushed back due to several factors, the most influential of which was issues surrounding dual-coding standards.

"There's commotion over the possibility of yet another ICD-10 delay."

The delay was good news for many providers in need of additional time to implement changes, but other stakeholders were in an uproar over the notion that the U.S. health care industry would fall even further behind on ICD-10 implementation. So it's no surprise that there has been a great commotion over the possibility of yet another delay.

why are some calling for a Is an ICD-10 delay really in the future?
According to Health Data Management, Congress will attempt yet again to find a permanent solution to the Medicare Sustainable Growth Rate formula for physician reimbursement. The SGR formula has been a source of stress on ICD-10 implementation for quite some time. In April 2014, the White House passed a bill that created a one-year solution known as the "doc fix," extending the deadline to October 2015 and calling for other provisions to avoid major cuts to Medicare payouts to doctors.

With that quick fix expiring, providers could see an astounding 20 percent or more decrease in their Medicare payments. That's why lawmakers are stepping in to find a permanent "doc fix" by the end of March, before the Medicare SGR kicks in April 1. The bad news is that another SGR delay is likely in the future, which could mean another setback for the ICD-10 deadline as amendments may be required to address new changes to the payment mechanism.

Many stakeholders have taken to Twitter to express their concern over the prospect of another ICD-10 delay:

A potential permanent 'doc fix'
There is a path to a permanent solution that has been the focus of many health care conversations as of late: a dual-coding contingency plan. This would allow practices to send medical claims with either ICD-9 or ICD-10 coding. During a hearing of the House Energy and Commerce Committee's Subcommittee on Health on Feb. 11, one speaker voiced his opinion about the need for dual coding.

As Health IT Outcomes reported, Dr. William Jefferson Terry, a practicing urologist speaking on behalf of the American Urological Association, emphasized that the CMS should turn to dual coding if the October 2015 deadline is to stay in place.

"If a delay is not possible, I urge you to consider legislating a dual ICD-9/ICD-10 option so that physicians will have time to transition to the new coding system, especially those nearing retirement or those with a demonstrable hardship that limits their ability to adopt ICD-10 by the deadline," Terry stated during the hearing.

A fix to avoid a major cut in Medicare payments may lead to another extension of the ICD-10 deadline.A fix to avoid a major cut in Medicare payments may lead to another extension of the ICD-10 deadline, currently set for Oct. 1, 2015.

However, some organizations are against the use of a dual-coding system, as it could enhance the potential for unforeseen complications such as conflicting codes and confusion during health information exchange. Such a system may also further delay the inevitable, industry-wide switch to ICD-10.

Whether or not dual coding becomes an option, it's clear that the vast majority of providers and other stakeholders support keeping the October 2015 deadline.

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