Electronic Health Records

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Bill Mandates Transition Period During ICD-10 Implementation

By Vera Gruessner

Healthcare providers who are preparing for the ICD-10 implementation starting on October 1 may be offered an ICD-10 transition period as well. A new House of Representatives bill H.R.2247 called Increasing Clarity for Doctors by Transitioning Effectively Now Act (ICD-TEN Act) mandates the “Secretary of Health and Human Services (HHS) to provide for transparent testing to assess the transition under the Medicare fee-for-service claims processing system from the ICD-9 to the ICD-10 standard, and for other purposes.”

The bill was issued by Representative Diane Black (R-TN-6) on May 12. The bill does not seek to delay the ICD-10 implementation period nor does it ask for there to be a dual coding system incorporating both ICD-9 and ICD-10, according to the Journal of AHIMA.

The bill asks for the Department of Health and Human Services (HHS) to conduct end-to-end testing among all providers to ensure that their Medicare fee-for-service claims system is working effectively and is compliant with the ICD-10 codes.

The ICD-10 transition period would take place over 18 months after which HHS would send a report to Congress stating whether the ICD-10 implementation is successful and not blocking the provision of provider claims. Essentially, the Centers of Medicare & Medicaid Services (CMS) would need to show that they are processing and approving the same amount of claims as in previous years under the ICD-9 coding set. The bill also states that if the ICD-10 implementation is not considered “functional” at that point by Congress, HHS would need to develop more methodology to ensure that the new coding set is working properly in the near future.

“During the ICD-10 transitional period, it is essential for CMS to ensure a fully functioning payment system and institute safeguards that prevent physicians and hospitals from being unfairly penalized due to coding errors,” Black wrote in a letter to Congress.




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