ICD-10 delay in proposed SGR bill

***Story updated to include statements by the American Medical Association and the College of Healthcare Information Management Executives***

As part of new legislation that would provide a 12-month patch for relief from the sustainable growth rate, implementation of ICD-10 would be delayed until no sooner than Oct. 1, 2015.

Section 212 of the bill states that the Secretary of the U.S. Department of Health & Human Services "may not, prior to October 1, 2015, adopt ICD-10 code sets as the standard for code sets."

The bill is set to go to the House floor for a vote Thursday, according to the Journal of the American Health Information Management Association. AHIMA is alerting its members to reach out to Congress to get the ICD-10 language taken out of the legislation.

The Centers for Medicare & Medicaid Services has continually said no further delays would be enacted.

After announcing in February that it would conduct 'end-to-end' testing for some providers for the ICD-10 implementation process, CMS this month specified that the testing will take place at the end of July. Five-hundred volunteers will be selected for the testing, which includes 32 testers from each Medicare Administrative Contractor. The testing comes in the wake of criticism by the American Medical Association, which published a report in February concluding that ICD-10 implementation costs will be more expensive than previous estimates for physician practices. Several groups--including the Medical Group Management Association, the American Hospital Association and the Workgroup for Electronic Data Interchange--previously had called for CMS to consider end-to-end testing in preparation for the switch.

In August 2012, HHS pushed back the implementation of ICD-10 from Oct. 1, 2013 to Oct. 1, 2014.

At the College of Healthcare Information Management Executives CIO forum in Orlando, Fla., last month, Marc Probst, CIO at Salt Lake City-based Intermountain Healthcare, said that ICD-10 should happen this year, despite the difficulties that lie ahead.

"I would say October is going to be a really difficult month—and costly from a cash-flow perspective," Probst told FierceHealthIT. "Still, I do think we ought to go with [ICD-10] this October. Just rip that freaking Band-Aid off and get going."

Despite being one of the most outspoken opponents of the transition to ICD-10, the AMA urged House members to vote against the legislation. 

"By extending the Medicare provider sequester and 'cherry picking' a number of cost savings provisions included in the bipartisan, bicameral framework, the 'Protecting Access to Medicare Act' actually undermines future passage of the permanent repeal framework," AMA President Ardis Dee Hoven said in a statement. "Further, it would perpetuate the program instability that now impedes the development and adoption of healthcare delivery and payment innovation that can improve healthcare and strengthen the Medicare program."

CHIME also expressed disapproval for the legislation, saying that any deviation from the current deadline would be "disruptive and costly for healthcare delivery innovation, payment reform, public health, and health care spending."

Added CHIME President and CEO Russell Branzell in the statement: "Further delay of ICD-10 discredits the considerable investment made by stakeholders across the country to modernize healthcare delivery. Providers have already dedicated significant time and resources in financing, training and implementing the necessary changes to workflow and clinical documentation."

To learn more:
- here's the proposed legislation (.pdf)
- here's the Journal of AHIMA post
- check out AHIMA's alert
- read the AMA statement
- here's the CHIME statement

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