ICD 10 Coding Alert

Experts say you shouldn’t fall into this “stop preparing” pitfall.

The entire healthcare community has been abuzz this month about the Protecting Access to Medicare Act of 2014. In a move designed to avert the 24 percent pay cut your practice was due to face on April 1, Congress introduced this bill — but the resulting temporary fix also included an ICD-10 delay buried in the text. 

Take a look at what you need to know to keep your practice up to date. 

Check Out the ICD-10 Changes

Mentioned about one-third of the way into the 121-page bill is a short paragraph that states, “The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD–10 code sets as the standard for code sets.” This means that since the bill has been signed into law, ICD-10 will be delayed for at least another year beyond the scheduled Oct. 1, 2014 implementation date. 

Remember: This is the second time ICD-10 implementation has been delayed. The original compliance date of October 1, 2013 was officially pushed back a year on September 5, 2012 by CMS. According to CMS this additional one-year delay of ICD-10 will likely cost the industry an additional $1 to $6.6 billion on top of the costs already incurred from the previous one-year delay.

Check Out AHIMA’s Take 

The American Health Information Management Association (AHIMA) spoke out against the delay. In a March 31 press release, AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE, FAHIMA, states: “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.” 

The press release goes on to say “Since the transition to ICD-10 remains inevitable and time-sensitive because of the potential risk to public health and the need to track, identify and analyze new clinical services and treatments available for patients, AHIMA will continue to help lend technical assistance and training to stakeholders as they are forced to navigate the challenge of continuing to prepare for ICD-10 while still using ICD-9.”

Avoid the ‘We Don’t Need to Keep Preparing’ Pitfall

While many feel this new law and resulting ICD-10 implementation delay is not good for practices, there may be a small silver lining. “I think it is a bad thing because it affects our momentum to crossing the finish line,” explains Laureen Jandroep, CPC, CPC-I, CMSCS, CHCI, senior instructor at CodingCertification.org in Oceanville, N.J.  “However we can use the extra time to prepare even more thoroughly so we can make the best of it.  For those that have made the investment getting ready it is frustrating to see their investment loose traction.”

Despite the delay in implementation, experts warn that practices must continue their efforts to preparing for ICD-10 use. “Part of the reason we’re in this situation is not enough people have prepared and petitioned for more time,” Jandroep says. “It is not fair to those that did prepare and are ready or were going to be by the 10/1/2014 date. The changes are in the implementation date, not that it is not coming at all, so prepare on!”

“Of note, we should not throw away the chance to improve the physician’s clinical documentation just because the code set implementation has been delayed,” Cobuzzi adds. “It is always a goal to improve clinical documentation.”

To read the complete text of the Protecting Access to Medicare Act of 2014, visit http://docs.house.gov/billsthisweek/20140324/BILLS-113hrSGR-sus.pdf.