Senate vote leaves 'unanswered questions' for ICD-10, critics say

Industry reaction to the Senate's passage of H.R. 4302 on Monday--which delays ICD-10 until at least Oct. 1, 2015, and provides a 12-month patch to the sustainable growth rate payment formula that will prevent deep Medicare payment cuts for physicians--appears to trend against the decision, with many groups expressing "deep disappointment" with the vote.

College of Healthcare Information Management Executives President and CEO Russell Branzell, in a prepared statement, said the legislation "discredits" the work of hospital CIOs and the healthcare industry at large to prepare for the transition to ICD-10.

"CMS must now provide new guidance to the industry on what the delay means for providers, vendors, clearinghouses and other concerned parties," Branzell said. "The delay leaves numerous unanswered questions from testing, training and revamping the agency's education resources, such as the CMS eHealth University, designed to help providers understand, implement and successfully participate in the conversion process."

Branzell also criticized the timing of the delay, saying that the more intricate coding system could have helped providers with implementation of new care models such as patient-centered medical homes and value-based purchasing.

The American Health Information Management Association also denounced the vote, saying that ICD-10 "remains inevitable and time-sensitive" for public health reasons. "The United States remains one of the only developed countries that has not made the transition to ICD-10 or a clinical modification, a more modern, robust and precise coding system that is essential to fully realize the benefits of the investments in electronic health records and maximize health information exchange," AHIMA's statement said.

The American College of Radiology, however, lauded the vote, saying in a statement that H.R. 4302 will "make healthcare more efficient, raise medical imaging quality, improve utilization accuracy and make physician payment policy more transparent." The legislation calls on the secretary of the U.S. Department of Health & Human Services to "identify mechanisms … by which ordering professionals can consult" physician-developed appropriateness criteria when prescribing advanced imaging procedures for Medicare patients.

"As medical imaging is the cutting edge of modern medicine, this requirement is a major step forward in healthcare reform," Paul Ellenbogen, chair of the ACR board of chancellors, said. "This will reduce unnecessary costs and help pave the way for a more responsive and efficient healthcare system."

ACR also supports the delay of ICD-10.

To learn more:
- here's the CHIME statement
- read AHIMA's statement
- here's ACR's statement