On Monday, the Senate voted 64-35 to pass a House-approved measure (HR 4302) that would delay a scheduled 24% cut to Medicare physician reimbursement rates and push the ICD-10 compliance deadline to 2015, Modern Healthcare reports (Hollander, Modern Healthcare, 3/31).
The bill now goes to President Obama, who is expected to sign it before the scheduled cuts take effect on Tuesday (Lowery, “Post Politics,” Washington Post, 3/31).
Background on ICD-10
U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch means that health care providers and insurers will have to change out about 14,000 codes for about 69,000 codes.
In August 2012, HHS released a final rule that officially delayed the ICD-10 compliance date from Oct. 1, 2013, to Oct. 1, 2014, partially to look at the incremental changes needed in reforming health care.
How Bill Would Affect ICD-10
The “doc fix” legislation, introduced by Rep. Joseph Pitts (R-Pa.), would push back the ICD-10 compliance date until at least October 2015.
The measure states, “The Secretary of Health and Human Service may not, prior to Oct. 1, 2015, adopt ICD-10 code sets as the standard for codes sets.” It also cites sections in the Social Security Act and the Code of Federal Regulations, which contain the secretary’s authority to mandate the new code sets.
CMS estimates that a one-year delay of ICD-10 could cost between $1 billion and $6.6 billion, according to a blog post by the American Health Information Management Association, which opposes the bill (iHealthBeat, 3/28).
AHIMA in a message to its members said the inclusion of the ICD-10 delay in the ‘doc fix’ bill likely was done to placate physicians who are against a [sustainable growth rate] patch” (Goedert, Health Data Management, 3/28).
In a statement, College of Healthcare Information Management Executives President and CEO Russell Branzell criticized Congress for passing the bill, saying, “Further delay of ICD-10 discredits the considerable investment made by stakeholders across the country to modernize health care delivery.” He added, “Providers have already dedicated significant time and resources in financing, training and implementing the necessary changes to workflow and clinical documentation. Any disruption to the ICD-10 transition at this stage would be detrimental.”
The American Podiatric Medical Association also criticized the delay. The group in a statement said, “While the delay does allow for additional time for preparation, it poses a significant financial and resource impact on entities that were heavily invested in the transition” (Bresnick, EHR Intelligence, 3/31).
AHIMA CEO Lynne Thomas Gordon in a statement called the delay “unfortunate,” noting that it directly affects at least 25,000 students who learned in health information management educational programs how to code exclusively in ICD-10 (Walsh, Clinical Innovation & Technology, 3/31). AHIMA also said it would seek clarification on the bill’s language, which described the delay as being “at least one year.” Thomas Gordon said, “On behalf of our more than 72,000 members who have prepared for ICD-10 in good faith, AHIMA will seek immediate clarification on a number of technical issues such as the exact length of the delay” (Modern Healthcare, 3/31).
However, other health care providers welcomed the ICD-10 delay.
Terry Gunn, CEO of KershawHealth in South Carolina, said the delay would give the hospital more time to get ready for the “huge, overwhelming task” of ICD-10 implementation.
After the House vote last week, Medical Group Management Association senior policy adviser Robert Tennant said that the proposed delay is “recognition that the industry is simply not ready for the transition” (iHealthBeat, 3/28).