What does the ICD-10 delay mean for physicians?

April 04, 2014
Area(s) of Interest: Payor Issues and Reimbursement Practice Management 

The ICD-10 compliance date will be delayed by at least one year, based on a provision in a federal law signed Tuesday that pushes the date to no sooner than October 1, 2015. It is unclear at this time how this unexpected delay will impact the health care industry, which has been feverishly working to prepare for the transition to the new code sets, previously scheduled for October 1, 2014.

The International Classification of Disease tenth revision (ICD-10) is a system of coding created in 1992 as the successor to the previous ICD-9 system. ICD-10 will include new procedures and diagnoses, which United States Department of Health and Human Services (HHS) hopes will improve the quality of information available for quality improvement and payment purposes.

For many, particularly smaller physician practices who were struggling to meet the October 2014 deadline, the delay is a welcome one. Some industry stakeholders, however, have already invested a lot of time and money to prepare for the transition and are worried that the delay will make an already costly and complicated transition even more so.

What everyone does agree on is that HHS needs to provide more clarity about the new law.

Among the questions the California Medical Association (CMA) is hearing are:

  • Will the Centers for Medicare and Medicaid Services (CMS) offer a dual use period during which either code set can be used?

  • Is CMS considering skipping ICD-10 and instead implementing ICD-11, which is scheduled to be released in 2017?

  • Should practices continue training and testing as planned? Or should they suspend all such activities until they receive further guidance from CMS?

  • CMA is closely monitoring the situation and will provide additional information as it becomes available.

    Contact: CMA's reimbursement help line, (888) 401-5911 or economicservices@cmadocs.org.


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