ICD-10 Update

Meaningful Help for “Meaningful Use”

ICD-10: Will it be Delayed Again?

Many physicians who in the past prided themselves on their independence are now looking at selling their practices or signing on with an outsourcing partner to help with billing and coding. What is the root cause of this change? Well there are many factors that may be causing this but one of the most common is the forced implementation of the ICD-10 codes (International Statistical Classification of Diseases) scheduled for October, 2015. The transition from ICD-9 to ICD-10, which has already been delayed multiple times, will result in an increase in codes from about 13,000 to over 68,000 codes. This will require software changes to relatively new Electronic Medical Records (EMR) systems and more concerning is the training it will take to get doctors and their staff up to speed.

The following is from The Physicians Foundation – a nonprofit organization that seeks to advance the work of practicing physicians and help facilitate the delivery of healthcare to patients – This is based on the Foundation’s insights into the medical practice landscape, supported by data from its 2014 Biennial Physician Survey of 20,000 physicians:

Impact of ICD-10 on Physician Medical Practices

According to the Foundation’s 2014 Biennial Physician Survey, 50 percent of respondents indicated that ICD-10 will cause severe administrative problems in their practices. Moreover, 75 percent of respondents said ICD-10 will unnecessarily complicate coding.  The implementation of ICD-10 will be highly disruptive for physicians and their medical practices and will result in lost time with patients. Despite these challenges and although the federal government delayed the implementation of ICD-10 to October 1, 2015, physicians and providers cannot afford to delay planning and engagement. The preparation and implementation will require an investment of time and resources, but if medical practices continue to delay, it will result in cash flow disruption and lost revenue. Actionable steps must be implemented early in the year to ensure sufficient preparation, including auditing internal IT platforms and making key updates to computer systems.

Given these concerns, at the end of April, Representative Ted Poe (R-TX) introduced legislation (HR 2126) that seeks to halt the implementation of the new ICD-10, explaining that, “instead of hiring one more doctor or nurse to help patients, medical practices are having to spend tens of thousands of dollars just to hire an administrative specialist who understands the new codes.”  While on May 12 Representative Diane Black (R-TN) introduced the ICD-TEN Act, which proposes developing an elongated ICD-10 transition period.

The American Medical Association and multiple state medical societies are in support of the Poe legislation. In response to the new compliance date, AMA President-elect Steven J. Stack stated, "While the AMA appreciates that physicians have additional time to comply with ICD-10, we continue to have fundamental concerns about ICD-10 and its implementation, which will not be resolved by the extra time. The AMA has long considered ICD-10 to be a massive unfunded mandate that comes at a time when physicians are trying to meet several other federal technology requirements and risk penalties if they fail to do so” (per

Even with much of the medical community’s opposition the Centers for Medicare & Medicaid Services (CMS) is continuing with the planned implementation date of October 1, 2015. CMS recently released the results of ICD-10 testing and they found that CMS accepted 88 percent of the test claims – this is up from 81% in the initial testing round. The normal Fee-for-service (FFS) Medicare claims acceptance rates average 95-98 percent. This testing also demonstrated that CMS systems are ready to accept ICD-10 claims.

Prepare for October 1st implementation or hope for another delay?

I’m sure the statement “hope is not a strategy” rings in many practice leaders ears. The odds of congressional action delaying the implementation is thought to be remote so experts advise working toward the October 1st date. Six of seven healthcare officials who testified at a February 2015 Congressional hearing stated that they felt ICD-10 should not be delayed again.

“We need to end the uncertainty,” said Representative Joe Pitts (R-PA), chair of the Energy and Commerce Committee’s Subcommittee on Health which held the hearing. “No more delays in the transition to ICD-10”, added Representative Kathy Carter (D-FL).

If ISC can be of any help as you continue to work through these changes please let us know.