Updated on: March 17, 2016

Forcing CMS’s Hand to Reveal October 2015 ICD-10 Implementation Deadline

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Original story posted on: May 5, 2014

Like a parishioner striking a lone church bell in a town square to herald the start of services, the Centers for Medicare & Medicaid Services (CMS) recently announced that it would issue an interim final rule signaling its intention to make October 2015 the new deadline for the implementation of ICD-10.

CMS made the announcement last Thursday, May 1 — marking a story that was duly reported by a number of online healthcare trade publications and professional organizations. Getting CMS to make the announcement took a village, or so it would seem.

 

The backstory appears to be less complicated than the efforts underway here in Southern California to have Los Angeles Clippers Owner Donald Sterling ousted from the NBA.

The inkling of a possible announcement surfaced in a reading of the 2015 Inpatient Prospective Payment proposed rule that CMS had published Wednesday evening, April 30 — ironically, 30 days after the congressional vote to approve a short-term solution to prevent cuts to physician payments, which would have occurred under the contentious sustainable growth rate formula. Included in one section of the legislation was the delay in the adoption of ICD-10 code sets until at least Oct. 1, 2015.

Early Thursday morning, most of the online healthcare news publications led with a story about the IPPS proposed rule, focusing on provisions of the controversial two-midnight rule. But ICD10monitor editorial folks read the IPPS proposed rule and quickly found unreported references to the ICD-10 deadline on page 648 and again on pages 1065 and 1074.

The immediate reaction was to consider that perhaps CMS had made an inadvertent misstep. ICD10monitor sent an early-morning email to Devin Jopp, president and CEO for the Workgroup for Electronic Data Exchange (WEDI). The evening before, WEDI had wrapped up its one-day ICD-10 Emergency Summit, which was held by the organization to solicit input from a diverse cross-section of stakeholders trying to determine how to move forward. The lack of a date from CMS marked a recurring concern voiced during the daylong summit held in Reston, Va.

Jopp’s response was immediate, having already read the IPPS proposed rule.

“I do not think this is inadvertent on the part of CMS and believe this is a way for CMS to set a new date without going back through a separate rulemaking process,” Jopp wrote in an email to ICD10monitor. “This same approach was taken last time, when ICD-10 was delayed as part of an unrelated regulation. WEDI will continue to work with its members and will operate under the assumption that we need to all work together to hit a Oct. 1, 2015 deadline.”

While still in the early morning, ICD10monitor contacted healthcare IT guru Stanley Nachimson, on whose watch the country’s healthcare system painfully labored through the 4010 upgrade while he was an official at CMS. Nachimson, while on a phone call with ICD10monitor, momentarily considered the possibility that this disclosure of the October 2015 date in the IPPS proposed rule could be considered breaking news.

A short while later, Nachimson who, by now had read the rule in its entirety, responded to ICD10monitor.

“The ICD-10 date does not appear to be a proposal in this rule,” Nachimson wrote in an email. “On page 128, the NPRM (notice of proposed rulemaking) says of the delay in the law ‘As of now, the Secretary has not implemented this provision under HIPAA.’” 

Nachimson said that while the 2015 IPPS proposed rule might seem to indicate that there is a one-year delay, there was nothing in the language that indicates a proposed new deadline date, he concluded. 

“We would have to see the exact wording of the proposed rule (not just the preamble),” Nachimson said. “I don’t think this is a proposal for a new date that they are seeking comments on.”

In the meantime, ICD10monitor sent an email to Robert Tennant, senior policy advisor for the Medical Group Management Association (MGMA), for a reaction to the IPPS proposed rule. Tennant, who is the WEDI vice chair of marketing communications, had participated in WEDI’s summit the day before.

Tennant told ICD10monitor that he wasn’t sure the notice was an “official” notice of the new date.

“If it is in fact the agency’s regulatory announcement of the new date, this is a proposed rule and thus this ‘proposed’ date should be open to public comment,” Tennant said.

Around midday, ICD10monitor contacted the press office at CMS for a comment. CMS was silent.

With that last piece of information, ICD10monitor published on its website the story titled “Developing Story: CMS Says October 2015 Marks New ICD-10 Implementation Deadline.” Jopp, Tenannt and Nachimson were duly quoted.

Meanwhile, WEDI’s Jopp sent a memo to his organization’s membership on the date in the IPPS proposed rule.

“I wanted to take a moment to write you personally to let you know that, upon the conclusion of WEDI’s Emergency ICD-10 Summit held yesterday, CMS released the 2015 IPPS Proposed Rule, wherein CMS states on page 648 that ‘The ICD-10-CM/PCS transition is scheduled to take place on October 1, 2015.’” 

Jopp went on to explain that WEDI would continue “to work with (the) industry on moving forward with implementation and will operate under the assumption that we need to all work together to meet a October 1, 2015 ICD-10 deadline.”

“We will address the new ICD-10 deadline and its impact at our upcoming 23rd WEDI Annual National Conference in Hollywood, Calif. on May 12th to the 15th,” Jopp concluded.

The WEDI announcement almost went viral for the next couple of hours. Nachimson, too, had reviewed the WEDI email, and that was enough for him to take action early in the afternoon.

In an email to an official at CMS, Nachimson suggested that the agency come forward and make a statement — a definitive one, or at least as definitive as possible.

“I am sure that by now you have seen the email from Devin Jopp and others that says the IPPS rule is proposing Oct. 1, 2015 as the new ICD-10 date,” Nachimson wrote. “My reading of the rule does not necessarily agree, but it would help the industry if you guys could clarify that the IPPS proposed rule is or is not setting a new ICD-10 adoption date.” 

Approximately two hours later, CMS responded to Nachimson, and perhaps others as well.

“Here is the official statement,” the CMS official said, responding to Nachimson. “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.”

Almost immediately, HIMSS Senior Director of Health Business Solutions Pam Jodock sent a memo to HIMSS ICD-10 stakeholders.

“Good afternoon, everyone,” Jodock wrote in her email. “As you know, HIMSS has been actively reaching out to CMS to offer its support in determining how best to move forward given the recent delay in ICD-10 implementation. Earlier this afternoon we received the following message from our contacts within the Agency:”

The CMS statement followed.

By the end of the day, all of the major online news organizations were leading with breaking news about the CMS statement.

Actually, to force CMS’s hand on Thursday didn’t take a village, after all — just the peripatetic Nachimson.

Now we just need to wait for the interim final rule.

Standing by.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.
Chuck Buck

Chuck Buck is the publisher of ICD10monitor and is the executive producer and program host of Talk Ten Tuesdays.