In response to the Senate's silence on ICD-10, a word about the delay

The importance of ICD-10 to legislators in the context of the sustainable growth rate patch was made abundantly clear by the number of mentions the implementation received in more than three hours of debate preceding the bill's vote Monday evening.

For those who didn't have the distinct pleasure of watching every second of the proceedings, U.S. Senators mentioned the ICD-10 portion of H.R. 4302, The Protecting Access to Medicare Act, a grand total of zero times; not one word. Considering the measure--all seven lines--was seemingly slipped into the middle of the bill, cloak-and-dagger style, even 10 seconds devoted to ICD-10 would have been better than nothing at all.

Of course, the transition--now delayed for the second time in nearly two years--is anything but a trivial pursuit for hospital providers who were finally prepared to make the leap from the ICD-9 coding system. And, unlike the Senate, they didn't hesitate to talk to FierceHealthIT about it.

"Significant efforts and dollars have gone into readiness," Sue Schade, CIO at the University of Michigan Hospitals and Health Centers told FierceHealthIT via email. She added that a delay only increases the amount of resources needed.

Roger Neal, vice president and CIO at Duncan (Okla.) Regional Hospital, agreed with Schade. "I think delaying ICD-10 for those who have been working on it and have spent tons of cash to get all of their systems in place, tested and moving is one of the worst things that can happen," he told me in an email.

Jeff Smith, director of federal relations for the College of Healthcare Information Management Executives--which expressed dismay with the measure shortly after the Senate vote was made official--told FierceHealthIT that the delay essentially rewinds the clock to 2012 for the healthcare industry.

"[I]t's not clear at all that we can keep doing this at the price levels," he said. "It's not clear that this time next year, we'll be in a position to put forth a full repeal bill for the same amount of money. Obviously money was the sticking point this time around; people couldn't agree how to pay for the thing in bulk."

What's more, the American Health Information Management Association, in its statement chiding the vote, said that a delay "casts a cloud on the employment of more than 25,000 students," all of whom have been trained to code exclusively in ICD-10 in anticipation of the transition. "As demands for quality healthcare data continue to increase, this delay will add an additional significant hurdle for the healthcare system to fill these important [health information management] positions," AHIMA CEO Lynne Thomas Gordon said.

AHIMA's statement also noted that a delay likely will cost the healthcare industry an additional $1 billion to $6.6 billion on top of costs already incurred from the previous delay. "This does not include the lost opportunity costs of failing to move to a more effective code set," the statement pointed out.

Between the waste of money and the inability to move forward with a code set that, according to the World Health Organization, is already being used by much of the rest of the world, you would think there might be something worth mentioning--especially considering the delay was important enough for inclusion in the bill in the first place.

Too bad the Senate didn't see it that way. - Dan @FierceHealthIT

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