Updated on: March 17, 2016

CMS Breaks Silence on ICD-10; Delay is Not a Killer

By Chuck Buck, Kim Charland, and Rhonda Taller
Original story posted on: April 23, 2014

WASHINGTON, D.C. — “The delay is not a killer for ICD-10,” the Centers for Medicare & Medicaid Services’(CMS’s) Denise Buenning told members of the American Health Information Management Association (AHIMA) during a Wednesday meeting.

Speaking before an audience of several hundred at the AHIMA ICD-10 Summit, Buenning acknowledged that the recent congressional move to delay ICD-10 implementation was a surprise.


“I think we were as surprised as all of you,” Buenning told the audience, admitting that the vote by Congress “(has) been hard for all of us at CMS.”

“My first reaction to the congressional action was thinking of individuals in coding schools,” she added.

In responding to questions from the audience, Buenning said CMS has had “multiple conversations on this (the delay) internally” and that “HHS will be making an announcement shortly.” Buenning also said that CMS is keeping to its regular schedule with meetings and committees and that “CMS is behind ICD-10.”

Buenning said that CMS looked at the law and that its general counsel will be developing an option to present to CMS Administrator Marilyn Tavener, who will take it to the management level and the U.S. Department of Health and Human Services secretary for approval – but she added that the “actual announcement will come from HHS.”

“The messaging will come through CMS,” Buenning explained.

In answering a smattering of questions from the audience, Buenning used the approximately 20-minute appearance to offer several pieces of information:

About rumors that that CMS was not ready: “We were ready. (We) didn’t expect it (the delay) to come from Congress.”

On plans for end-to-end testing: “They (CMS) had been planning end-to-end testing in July, but with that date change they’re not certain.” Buenning also explained that CMS only has so much money for testing. “What this (the delay) gives us is another year for testing, and (it) would allow for more robust testing with providers,” she said.

On CMS readiness for ICD-10: “CMS was ready for the Oct. 1 date; testing (was) going well and systems (were) ‘go’ for switch over a year ago.”

On how to prevent a delay from happening again: “CMS started a few months ago a small physician initiative to help MDs,” she said. “We all need to communicate better with physicians on the benefits of ICD-10. We can work through various associations, as there are strengths in numbers. Everyone listens when the industry is together.”

On the code freeze: Buenning explained that a decision on the code freeze would come from the Coordination and Maintenance Committee.

Buenning’s remarks represented the first public statement from CMS since it went radio-silent after President Barack Obama signed the Protecting Access to Medicare Act on April 1. The legislation prohibits the U.S. Department of Health and Human Services (HHS) from implementing ICD-10 before October 2015.

Buenning is the acting deputy director of the CMS Office of E-Health Standards and Services. Her appearance was billed by AHIMA as the “CMS ICD-10 Report on the State of the Union.”

Buenning’s remarks came one day after the unexpected resignation of Jonathan Blum, principal deputy administrator for Medicare, as announced by CMS Administrator Marilyn Tavenner. Blum, who is widely credited for developing the Accountable Care Organizations for the Obama Administration, is scheduled to step down May 16, according to media reports. On Blum’s watch, CMS released Medicare physician payment data on more than 800,000 physicians.

Earlier this month, on April 11, U.S. Department of Health and Human Services Secretary Kathleen Sebelius resigned, prompting President Obama to nominate Sylvia Mathews Burwell, the current director of the Office of Budget and Management, to replace her.