CMS Resets ICD-10 Start Date

The Department of Health and Human Services "expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015. The rule will also require HIPAA-covered entities to continue to use ICD-9-CM through September 30, 2015."

After one month of silence, the federal government has announced that it will reset ICD-10 implementation for Oct. 1, 2015, the earliest date allowed by law.

"We are so happy about this," Lynne Gordon Thomas, CEO of the American Health Information Management Association said in a telephone interview Thursday evening.

"It gets the momentum back. Our fear was that people are going to say 'we don't know when it's going to be. We have so much going on in healthcare right now that you can only concentrate on so many things at one time.' We wanted to make sure this didn't get lost in the shuffle."

The ICD-10 delay was slipped into a larger bill that also delayed implementation of the Sustainable Growth Rate funding formula. The Protecting Access to Medicare Act of 2014 was hustled through Congress just before the SGR cuts were to take effect, and it was quietly signed into law by President Obama.

For Hospital CFOs, ICD-10 Delay a Costly Disappointment

Since then, frustrated advocates for ICD-10 have been hounding the Department of Health and Human Services and the Centers for Medicare & Medicaid Services for specifics on when they planned to reset a new implementation date for the coding set.

On Thursday afternoon advocates got their answer when CMS issued the following statement:

"On April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93) was enacted, which said that the Secretary may not adopt ICD-10 prior to October 1, 2015. Accordingly, the U.S. Department of Health and Human Services expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through September 30, 2015."

The fickle action by Congress to stuff the delay into a larger bill with no advance warning, and the federal bureaucracy's unwillingness to communicate on a reset date prompted the Commission on Certification for Health Informatics and Information Management to announce that it would hold off on testing for ICD-10 accreditation until the new coding set is "officially implemented."

CMS Silence on ICD-10 Holds Healthcare Hostage

The new implementation date provides a target for providers, many of them were left in limbo after planning for the Oct. 1, 2014 startup, which had already been delayed by one year in 2013. Gordon Thomas says many providers have been restless with the delay.

"What we are hearing is everybody wants to move on," she says. "It's been frustrating to the healthcare community because we want to move on and it's tough on people when there is indecision. So, I think people will be very pleased."

Because CMS plans to issue an interim final rule, Gordon Thomas says, it's not clear if it will ask for public comments or what other regulatory steps will be taken before the new implementation date becomes final.

The ICD-10 delay had been sought by specialty physician associations that have long questioned the value and cost of the coding set. Gordon Thomas says ICD-10 backers should spend the next year addressing the concerns of physicians and other skeptics.

"We are really developing a strategy," she says. "We've talked to CMS about working with small physician practices. We want to make sure they understand why it's important, and empathize with them and help them."

"They've been a little scared from what they are hearing, so we are going to be putting out 'mythbusters' literature telling them 'this is what you are hearing, but here are the facts.' It is a change. They are asked to do more documentation but they need to do that whether we go to ICD-10 or something else like value-based purchasing."

ICD-10 Delay Alters Provider, Vendor Prep

Otherwise, Gordon Thomas says providers should use the additional 12-months to provide.

"We want people to take advantage of this extra time," she says. "They need to continue to work on their clinical documentation improvement programs. The need to train their staff and stakeholders, whoever that may be, and at the appropriate level of training depending upon what they need. They should continue working with dual coding, and they should work with their vendors to make sure that they are ready, ready, ready."