Updated on: March 17, 2016

House Votes to Delay ICD-10 Implementation

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Original story posted on: March 27, 2014

The fix is in.

The U.S. House of Representatives today voted to extend the deadline for implementing ICD-10 by one year, pushing the mandatory compliance date to October 2015. The Senate is expected to vote tomorrow.

 

The provision for extending the delay was tucked into the House bill to extend the Sustainable Growth Rate (SGR) formula for another 12 months rather than finding a permanent solution to the 1997 Balanced Budget Act, which attempted to rein in Medicare reimbursement to physicians. Annual “doc fixes” to temporarily repeal the SGR have become an existential rite of spring, as Congress has continued to forestall a scheduled 24-percent reduction to physician reimbursement that would have kicked in April 1.

Media reports yesterday indicated that House Speaker John Boehner (R-Ohio) and Senate Majority Leader Harry Reid (D-Nev.) had reached an agreement on the legislation — a signal that the Senate would vote tomorrow on the bill that will extend for a second time the deadline by which ICD-10 will be enacted.

Politics of Reality

“The reality is that a lot of small community and indigent hospitals rely on their state or local government for the capital that they need to make the change to ICD-10,” Monitor Monday legislative analyst Emily Evans, a partner at the Obsidian Research Group, wrote in an email to ICD10monitor. “I think that all lot of them would not have made the deadline.”

Evans believes that members of Congress, especially those from rural areas, were hearing about ICD-10 and the time needed to make the conversion.

“I think that Congress prepared to vote for a delay and that the IT lobbyists worked hard to shorten the delay to one year. Some didn’t want ICD-10 (at all),” Evans added. “Of course, some Republicans don’t like ICD-10. They make fun of it.”

Sound and Flurry

Today’s House vote occurred in spite of assurances from Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner that the compliance date was set in stone. The most recent public statement on the matter from Tavenner came when she addressed attendees at the Health Information and Management Systems Society conference last month, on Feb. 27.

Leading up to yesterday’s vote was a huge, last-minute phone campaign to legislators by members of the American Health Information Management Association (AHIMA), among others.

“After picking myself up off the floor with the AHIMA e-mail that legislation had been proposed in the House of Representatives to delay ICD-10, I went into action mode,” wrote Laurine Johnson of Peak Health Solutions in an email to ICD10monitor. “As I had just visited my senators and representative last week during AHIMA Hill Day, I telephoned each one of them and asked for the person who I met with last week.”

Johnson told ICD10monitor that she was able connect with one person live, but had to leave messages for the other two.

“I also followed up with an email to each senator and representative, explaining the burden that would be caused by delaying ICD-10 another year,” Johnson wrote.

A social media blitz was unleashed yesterday as well, with tweets such as this one from AHIMA president Angela Kennedy:

Angela Kennedy @_AngelaKennedy
Save a $billion! This country can't afford another delay. Vote NO to the SGR bill. No more delays for ICD-10! #ICD10 #SGR

The Association of Clinical Documentation Improvement Specialists also tweeted, urging Congress not to delay the implementation of ICD-10:

ACDIS @ACDIS
RT bonanza! #NoDelay! #ICD10... have you heard the news? ACDIS supports ICD-10 implementation date of October 1 2014. ow.ly/v0Xvg

The College of Healthcare Information Management Executives (CHIME) also “chimed” with this tweet of support:

CHIME @CIOCHIME
“CHIME joins @AHIMAResources for removal of #ICD10 delay provision; ICD-10 Coalition says delay much too costly coalitionforicd10.wordpress.com/2014/03/26/icd

Ironically, today’s House vote came two weeks after 200 members of AHIMA trekked to Capitol Hill to meet with the respective state legislators and to advocate for keeping the October 2014 date. At that time, AHIMA members were focused on two legislative challenges: HR 1701, the Cutting Costly Codes Act, introduced April 24, 2013, and S. 972, the amended Cutting Costly Codes Act, introduced May 16, 2013. Even then, members worried about the possibility that such a provision would be slipped into the SGR bill. And it was.

Looking Ahead

“The healthcare industry would be best served by continuing to prepare for ICD-10,” wrote Juliet Santos of Leidos Health. “If an extension is approved, the additional time should be used to update all impacted systems and conduct more thorough internal and external testing.”

Pondering the Impact

“Unfortunately, well-intentioned governmental actions sometimes have a profoundly detrimental impact,” said Paul Weygandt, vice president of physician services at J.A. Thomas & Associates (a Nuance company) in an email to ICD10monitor. “To a large extent, in response to an American Medical Association (AMA) request over one year ago, the implementation of ICD-10 was delayed from Oct. 1, 2013 to Oct. 1, 2014.”

The all-but-certain delay of ICD-10 comes tomorrow, when the Senate is expected to approve the bill.

“Like everyone in the industry, Precyse is closely watching the developments related to the SGR Bill and its effect on the transition to ICD-10,” wrote Precyse President Chris Powell, in an email to ICD10monitor. “If the bill is approved by the Senate and becomes law, it does not change our goals. There will still be no time to procrastinate. Providers should use any delay to continue staff education, improve their clinical documentation processes, and build a strong foundation for process improvement.”

SGR Bill, March 25, 2014

 

Chuck Buck

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