Provider groups stress more testing in reaction to ICD-10 deadline

A day after including language in its proposed Inpatient Prospective Payment Systems rule that hinted at a new ICD-10 deadline, the Centers for Medicare & Medicaid Services confirmed that it expects to release an interim rule soon officially setting a compliance date of Oct. 1, 2015.

In a statement emailed to FierceHealthIT Thursday, CMS said that the rule will require that provders use ICD-10 beginning Oct. 1, 2015; the rule also will require HIPAA covered entities to continue to use ICD-9-CM through Sept. 30, 2015.

In addition, CMS said that its previously planned end-to-end testing scheduled for July has been canceled due to the delay, but that additional testing will occur in 2015.

Early last month, the transition to ICD-10 was delayed for the second time in nearly two years when President Obama signed the Protecting Access to Medicare Act into law. The legislation mandated that ICD-10 could not be adopted prior to Oct. 1, 2015, and also implemented a 12-month patch to the sustainable growth rate payment formula that prevented deep Medicare payment cuts for physicians.

Reaction to the move by CMS from the healthcare industry has been mixed. Robert Tennant, a senior policy advisor for government affairs with the Medical Group Management Association--which was in favor of a delay--told FierceHealthIT via email that the process of ICD-10 implementation must be modified for physician practices to move forward successfully.

"Industry coordination between software vendors, clearinghouses and health plans has simply not occurred," Tennant told FierceHealthIT. "Medicare, for example, should be aggressively pursuing end-to-end testing with any willing trading partner. The more testing that is completed and the more the results of that testing are disseminated, the better chance the industry has of a successful transition.  If any one of the critical links in the chain are not ready then practices themselves cannot be ready."

Meanwhile, Jeff Smith, director of federal relations for the College of Healthcare Information Management Executives--which did not want a delay--told FierceHealthIT in a phone conversation that CHIME was encouraged by the announcement.

"We're happy to see HHS commit to a hard deadline," Smith said. "I think in so far as we were supportive of the 2014 deadline, we're happy that HHS has decided not to prolong further than what the Congressional language prohibited."

To that end, however, he, like Tennant, said that CMS must focus on coordinating testing for providers to have confidence in the deadline, and success with the implementation.

"The industry at large is going to have a hard time believing this 2015 deadline--and that's for people who support ICD-10, as well as those who oppose it," Smith said. "While we know this isn't CMS' fault, as far as most people are concerned, they're not differentiating between Congress and the administration; they just see the federal government.

"As long as CMS continues to have periodic educational sessions and they continue to conduct testing--in particular, the end-to-end testing--I think they can help" to ease industry skepticism.

Smith added that he would like to see CMS conduct more testing than it originally planned on conducting.

"I understand that there are budgetary constraints and they didn't plan for more testing and there may not be money for more testing, but I think it's important that they get ingenuitive here," Smith said.

The American Health Information Management Association applauded the announcement of the expected interim final rule from CMS.

"We know that the industry has already invested considerable time and money in implementation," an AHIMA statement said. "We have long advocated for a coding system that offers flexibility and specificity, enables us to properly assess healthcare services, understand public health needs and get the best rate of return from our national investment in EHRs and Meaningful Use."

To learn more:
- here's the AHIMA announcement

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