US House of Representatives approved ICD-10 delay until October 1, 2015 through a voice vote, in favor of passing the patch for the Sustainable Growth Rate (SGR).
The ICD-10 delay news is now confirmed, as the bill (HR 4302) is sure to be signed by President Obama, after US Senate voting. The ICD-10 delay bill is confirmed to be passed fron senate as, John Boehner (House Speaker) announced that he and Senate Majority Leader Harry Reid had agreed on the proposal.
SEC 212: DELAY IN TRANSITION FROM ICD–9 TO ICD–10 CODE SETS
The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD–10 code sets as the standard for code sets under section 1173(c) of the Social Security Act (42 U.S.C. 1320d–2(c)) and section 162.1002 of title 45, Code of Federal Regulations.
From October 1, 2014 the ICD-9 coding sets used to report medical diagnoses and inpatient procedures currently, was scheduled to be replaced by ICD-10 coding system. The transition to ICD-10 is required by CMS
for everyone covered by the Health Insurance Portability Accountability Act (HIPAA) and Affordable Care Act (Obamacare).
Although ICD-10 change does not affect CPT coding for outpatient procedures and physician services, ICD-10 implementation is still a huge step. That's why Provider Practices, Medical Billing Coding Companies, Medical Insurance Payers and all other stake holders in the United States healthcare panorama were in almost panic state almost aimed upcoming CMS ICD-10 compliance deadline.
Associations such as the American Medical Association (AMA) had asked their members to convince Congress of the need for a timely SGR repeal, with the failure to do by March 31, leading to a 24% cut in payments to physicians.
Medicare SGR Fix Bill 2014 details
Medicare SGR Fix Bill 2014 contains a slew of additional health care provisions and benefits for physicians, hospitals, drug makers and other providers:
- Grant Medicare physicians a 0.5% fee increase through the end of 2014.
- Provide higher Medicare payments to hospitals in rural areas and for ambulance services in such areas.
- Establish two new mental health grant programs, one of which would receive $60 million over four years to improve outpatient treatment for individuals with serious mental illnesses.
- Delay the deadline to implement the new ICD-10 diagnostic and procedure code sets by one year to Oct 1, 2015
- Delay implementation of the new inpatient payment rule for hospitals, known as the two-midnight rule, by six months, to March 2015.
- Implement $2 billion in payment reductions over 10 years to skilled nursing providers.
ICD-10 Delay Impact on Healthcare Industry
If the AHIMA numbers are even close to being correct, which I believe they are, this is going to cost the industry substantial amounts of money in the tune of $1 to $6 billion dollars, but most importantly loss of momentum and energy around something that really is important.
The ICD-10 implementation delay will also leave those healthcare services providers disadvantaged, who has prioritized ICD-10 compliance over other activities.
Is ICD-10 Compliance Delay Good or Bad?
A lot of people still see the rationale behind the ICD-10 compliance deadline delay. Most of these concerns came from the physicians, particularly Specialty Providers.
Although there were ways to deal with those. We could go to only the hospital side moving to ICD-10 and leaving physician-based payment on ICD-9 for another year, which is what they did in Canada for years. You could go to another model where we even did dual billing for several years and use this as a migration tool.
But the thing that needs to be re-prioritized from a timing perspective is actually meaningful use, which everybody has concerns about. The majority of hospitals, which also include a majority of the physicians employed within them, are comfortable with the time frame of ICD-10. Why would we delay that and not being looking at the other timeline?
There are lots of other things in the bill that are appropriate and need to be corrected. They need to deal with SGR, the overnight rule, and several other things that are in there. Those are appropriate. But when you include things in there that should stand on their own, you tend to create collateral damage
Back in October 2013, I wrote about ICD 10 Compliance Deadline Delay
. Now ICD-10 Compliance Deadline is once again delayed for another year. But ICD-10 Implementation is not selves and is still very much on the calendar. Isn't it really?