For the last six months, there was a big push for ICD-10. However, the implementation of ICD-10 has been delayed until October 1, 2015. The news is surely a big relief for many healthcare providers who were not ready to implement the new coding standards.
The U.S. Senate on March 31 approved H.R. 4302, the legislation which delays the ICD-10 implementation deadline by one year to October 1, 2015. The Senate voted 64-35 to pass the bill. President Barack Obama has signed into law “doc fix” legislation (HR 4302) to delay scheduled cuts to Medicare physician reimbursement rates. Along with suspending the projected 24% cut to Medicare Part B payments, the bill also postpones the “two-midnight rule” and recovery audits of medically unnecessary claims until March 2015.
According to a blog post by the American Health Information Management Association, “CMS estimates that a one year delay could cost between $1 billion to $6.6 billion”. However CMS has not yet said how it will translate the law into regulatory policy.
Reports suggest that there’s also an outside chance that the CMS might decide to skip ICD-10 entirely and shift focus to the ICD-11 standard currently under development. Amidst the controversies connected with the transition to ICD-10, The World Health Organization (WHO) has released a fact sheet noting that the final version of ICD-11 will be released in 2017, two years later than scheduled.
Is This Delay a Blessing or a Curse?
Though a few providers are happy with the delay of this new ICD code set, with less than six months until the earlier October 1, 2014 deadline, many clinics have already invested time and resources in upgrading their systems for ICD-10, contracting with vendors, and hiring consultants. Medical communities have already spent millions of dollars in educational grants from the HITECH Act to prepare workers for the ICD-10 transition. Staffs at reliable medical billing and coding companies were also ICD 10 ready. Now, with an extra 12 months before the deadline, their training process must continue for an additional year.
The hope with this new code set is that, with more detailed diagnosis codes available, the CMS and private payers will be able to process more insurance claims the first time they are submitted without requiring additional documentation.