February 11, 2015

Congress Not Likely to Stop ICD-10 Date

By Stanley Nachimson

I was eagerly awaiting Wednesday’s hearing to see what information would be presented to the U.S. House of Representatives Energy and Commerce Committee’s Subcommittee on Health. 

In opening statements, U.S. Rep. Joseph Pitts (R-Penn.), the chairman of the subcommittee, expressed his support for the Oct 1, 2015 date for implementation of ICD-10, so it was pretty clear that most of the witnesses were going to be supportive of that as well. 

However, there really was not much new information presented. The debate really centered on the short-term cost of implementation for providers versus the long-term benefits of ICD-10 for research, public health, and statistics.  

This is an issue that was certainly not resolved by the conclusion of the hearing and may never be. Some of the most interesting statements included the admission by John Hughes, MD, professor of medicine at the Yale School of Medicine, that ICD-10 will not have much impact on individual patients’ treatment at the provider’s office; the admission from Sue Bowman, senior director of coding policy and compliance for the American Health Information Management Association (AHIMA), that comparisons between the U.S. and other countries’ data were difficult to make because the code sets differ so much from country to country (and that implementation lessons are not always comparable, because only the U.S. uses the code set for billing and payment); and the statement by Edwin M. Burke, MD, that his practice incurred no cost in implementing ICD-10. Dr. Burke practices internal medicine in a small rural community in Missouri — a community of about 4,000 people.

There was also the admission that increases in denials and A/R days due to ICD-10 could be a significant hardship for physician offices.

The impression I came away with was that Congress will probably not step in to change the Oct. 1, 2015 date – barring any surprises in Medicare and health plan testing. 

Beyond that, both sides continue to stake their claims on the issue.

About the author

Stanley Nachimson is the founder of Nachimson Advisors, LLC.

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