Rich Daly | February 11, 2015
Although some physician advocates continue to raise concerns about cost, complexity, and reimbursement issues surrounding the coding switch, a new report indicates the lead federal agency will be prepared.
Feb. 11—Congressional support appears to be solidifying for avoiding any further delays in the scheduled October transition to a new set of order codes.
Several congressional healthcare leaders voiced support in recent days for keeping the healthcare industry’s transition to ICD-10 codes on its scheduled deadline of Oct. 1, 2015. Rep. Joseph R. Pitts (R-Pa.), chairman of the House Energy & Commerce Committee’s Health Subcommittee, joined several other members in supporting the scheduled transition during a Feb. 11 hearing to assess readiness.
“We need to end the uncertainty and to move forward with full implementation,” Pitts said.
That echoed the views of Sens. Orrin Hatch (R-Utah) and Ron Wyden (D-Ore.), chairman and ranking member, respectively, of the Senate Finance Committee, who said in a written statement that a recent Government Accountability Office (GAO) report gave them confidence that the Centers for Medicare & Medicaid Services (CMS) was adequately prepared to implement ICD-10 by October.
“While additional testing will be needed to ensure its success, the transition to the new system will streamline the management of healthcare records and improve patient care,” Hatch said in a release. “I will continue to keep a close eye on this issue but see no reason for any delay past the October deadline.”
Congress’ unexpected delay last year of the previously scheduled 2014 switch to the latest set of codes used to classify diseases and health issues in patient healthcare records had followed an earlier administrative delay by CMS. The postponements followed the objections of some physicians’ advocates that small and rural practices faced large financial hurdles in switching, that reimbursement could be jeopardized, and that the change would create additional requirements that reduce clinician interaction with patients.
“Those physicians who fail to understand the new codes will not document them and will fail to be paid,” said William Jefferson Terry, MD, a urologist who testified before the House panel for the American Urological Association.
Terry and several members of Congress who are critical of the transition cited CMS estimates that both payment denial rates and the time that bills spend in accounts receivable could increase. Some critics expressed support for a hybrid system in which both types of code sets are used, but health insurance advocates said payers would not be able to support such a system.
Transition Preparedness
Hospital, insurance, and health technology company advocates said that most healthcare entities are either ready for the transition or could soon become so for little cost. For instance, the ICD-10 transition costs for small physician practices are significantly lower than previously expected, according to a survey released Feb. 10 by the Professional Association of Health Care Office Management. The survey of 276 physician practices with fewer than six providers found their ICD-10 costs averaged $8,167.
Meanwhile, other providers underscored the cost of delay, which the U.S. Department of Health and Human Services estimates was $6.8 billion for last year’s postponement and could range from $1 billion to $6.6 billion for further delays.
Surveys by Premier, an alliance of about 3,400 hospitals, indicate that more than three-quarters of U.S. hospitals and health systems have been ready to use ICD-10 since 2014.
“We urge Congress to avoid any further delays in ICD-10 implementation, which is needed to keep up with advances in medicine and more accurate health information and payment,” Premier said in a written statement.
Source: HFMA