February 16, 2012

HHS to Initiate Rulemaking Process to Delay ICD-10


Just two days after Centers for Medicare and Medicaid Services acting administrator Marilyn Tavenner signaled the agency would re-examine the timeline for transitioning from ICD-9 to ICD-10, the Department of Health and Human Services (HHS) announced that it would initiate the rulemaking process to postpone the date for implementation of the new code set.

HHS Secretary Kathleen G. Sebelius, in a news release issued on Wednesday, Feb. 15, said the agency had heard from “many in the provider community who have concerns about the administrative burdens they face in the years ahead.”

There was no indication of when the rulemaking process would begin.

“This represents a failure on the part of both the industry and CMS,” said Stanley Nachimson, principal of Nachimson Advisors. “The industry has failed to properly manage well-known requirements, delaying important implementation steps until a failure to achieve compliance is imminent.”

The final rule adopting ICD-10 as the standard was published in January 2009 and established October 1, 2013 as the deadline for implementation—that date an extension of the 2008 in the proposed rule.

“ICD-10 was originally proposed in the ‘90s, and has been delayed many times, largely because the underlying systems needed to drive ICD-10 were inadequate,” said Chris Powell, president of Precyse. “Most providers have invested in more sophisticated systems that are now able to handle this work.

“While a delay may enable more providers to come into full compliance with ICD-10, many providers say postponing will be more expensive and cause more rework,” said Powell.

“While it is true that there are significant regulatory demands put upon hospitals at this time requiring significant funding and resource allocation such as CPOE, EMR/Meaningful Use, ICD-10 and Pay for Performance, it is nevertheless imperative for the industry to have certainty and foresight from government entities for budgeting and planning purposes,” said Rudy Braccili, Jr., executive director of revenue cycle services for Boca Raton Regional Hospital in south Florida.

In a written statement to its members, the American Health Information Management Association said it was considering a response to the news, noting that “the decision complicates not only the ICD-10-CM and PCS implementation, but also a number of other HHS programs associated with meaningful use, Medicare, and efforts to adopt electronic health records and health information exchange, as well as quality measurement, public health and patient safety, and research improvement.”

“CMS has failed by not appropriately publicizing the need and benefits of ICD-10 and providing necessary guidance and tools,” said Nachimson. “Perhaps we can all learn from this.”

Updated on September 23, 2013
Chuck Buck

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