Bill calls for 18-month ICD-10 grace period

A new bill introduced in the House would require end-to-end testing of the transition from ICD-9 to ICD-10 by the Health and Human Services Department, and would provide an 18-month transition period to the new code set.

The Increasing Clarity for Doctors by Transitioning Effectively Now Act (ICD-TEN Act), proposed by Rep. Diane Black (R-Tenn.), would not stop or delay implementation of the coding system, according to an article in the Journal of the American Health Information Management Association (AHIMA).

However, Black's bill would require HHS to offer the testing to all providers participating in the Medicare fee-for-service program. In addition, the agency would have to submit to Congress certification on whether the system is working, according to AHIMA. If HHS finds that the full transition is not occuring, it would need to take additional steps to ensure completion.

During the transition period, reimbursement claims submitted to Medicare could not be denied due to "use of an unspecified or inaccurate subcode."

The deadline for ICD-10 implementation has been delayed several times. Many providers, especially small practice physicians, still have concerns about the transition, with a recent survey finding only 11 percent of respondents "highly confident" their staff will be sufficiently trained by the Oct. 1 deadline to transition to the new code set; 35 percent said they were "not at all confident" their staff will be ready.

"Neither Congress nor the provider community support kicking the can down the road and supporting another delay, but we must ensure the transition does not unfairly cause burdens and risks to our providers, especially those serving Medicare patients," Black wrote in a letter urging fellow legislators to co-sponsor the bill, according to the article.

AHIMA officials do not support the proposed legislation, noting in the article that the Centers for Medicare & Medicaid Services-supported contingency plans already are in place. Margarita Valdez, senior director of congressional relations at AHIMA, said according to the article that the transition period would "create an environment that's ripe for fraud and abuse." Meanwhile, AHIMA CEO Lynne Thomas Gordon said she fears that providers would use the extra 18 months to "delay properly learning how to use the new code set."

There are some who would still like to see ICD-10 delayed yet again, or even thrown out.

Rep. Ted Poe (R-Texas) recently introduced a bill to Congress that would ban ICD-10 outright.

The Cutting Costly Codes Act of 2015 would prohibit the federal government from requiring medical professionals to comply with ICD-10 in lieu of ICD-9. 

To learn more:
- here's the bill
- read the AHIMA article