Questions abound as Congress passes ICD-10 delay bill

Hospitals and health care providers have been criticizing the Centers for Medicare and Medicaid Services' approach to the ICD-10 transition for months. From requests for more time and flexibility to concerns about the scope of end-to-end testing processes, it seemed that the majority of health care professionals wished ICD-10 would just go away.

However, the Senate's recent vote to pass a bill ostensibly aimed at patching the sustainable growth rate for physicians also contained a single clause that prohibited the CMS from making any changes to the current medical billing system until 2015 – effectively delaying ICD-10 for a full year. The bill will now move on to the desk of President Barack Obama, who is expected to sign the bill into law within 10 days, Health Data Management reported.

Potential resources lost
While the delay is not certain yet and any number of events could still change what actually happens on Oct. 1, 2014, many of the same health care organizations that called for a re-envisioning of the CMS' plan to introduce ICD-10 to the industry are now raising concerns over the financial toll that stopping all that preparation will have on their workflows.

The American Health Information Management Association was one of the most vocal opponents of an ICD-10 delay once the bill passed a vote in the House of Representatives.

"The health care industry has had an abundance of time to prepare for the transition to ICD-10," AHIMA officials said in a statement. "Many hospitals, health care systems, third-party payers and physicians' offices have prepared in good faith and made enormous investments to be ready for the Oct. 1, 2014, deadline and the transition to ICD-10, an essential and robust coding system that will lead to improved patient care, reduced costs and maximize the investments in electronic health records and health data exchange."

Russell P. Branzell, president and chief executive officer of the College of Healthcare Information Management Executives, told EHRIntelligence that his organization was disappointed that something as important as ICD-10 was voted on as a relatively small constituent part of a bill that primarily dealt with the SGR rate. 

"That's an area that needs to either stand on its own and be discussed on its own," Branzell said. "When you start combining all these programs together, none of them can be looked at on its own merits and concerns."

Concern from all corners
While the AHIMA and the CHIME represent the voices of health care professionals, those same executives could not keep quiet when months-going-on-years of difficult preparations suddenly became in jeopardy of being thrown away. Fierce Health IT spoke to several industry veterans who echoed similar concerns about arduous training processes now being for naught with the ICD-10 delay bill within one step of becoming law.

Roger Neal, vice president and chief information officer at Duncan Regional Hospital in Oklahoma, told Fierce Health IT that the abruptness of the postponement is at odds for the length of time that his and other organizations have worked to ready themselves for it. While ICD-10 preparation has not been cheap by any means, cutting the cord now will only increase the costs associated with later efforts, Neal explained.

Some professionals, such as Indranil Ganguly, vice president and chief information officer at JFK Health System in New Jersey, argued for a delay on meaningful use stage 2 requirements rather than ICD-10. Inadequate preparations for the latter may not have direct financial losses, but the same with the former means missing much-needed incentive payments.

If a one-year delay to ICD-10 is ratified by President Obama, Todd Richardson, senior vice president and chief information officer at Aspirus Inc. in Wisconsin, explained that skipping to ICD-11 might be the best option altogether.