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Congress expected to vote on potential ICD-10 delay

By Kyle Murphy, PhD

UPDATE: After this morning’s proceedings led to a postponement of a vote on HR 4302, the bill was reconsidered this afternoon and passed by a voice vote.

A bill before Congress if approved would delay the compliance date for ICD-10 until 2015, and it has led at least one prominent healthcare association to oppose it.

The main focus of the legislation — “Protecting Access to Medicare Act of 2014” — is to extend Medicare payments to physicians as well as a host of other Medicare and Medicare programs impacted by the Sustainable Growth Rate (SGR), something Congress has attempted but so far been unable to repeal.

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Section 212, however, includes important language concerning the transition to ICD-10 that has not appeared in previous attempts at repealing the SGR. It’s this nugget of information:


The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD–10 code sets as the standard for code sets under section 1173(c) of the Social Security Act (42 U.S.C. 1320d–2(c)) and section 162.1002 of title 45, Code of Federal Regulations.

According to an announcement by the American Health Information Management Association (AHIMA), the bill is slated to be voted by the House of Representatives on March 27. “This bill was negotiated at the leadership level in the House and Senate, and it is expected that there will be no debate before calling the bill to vote,” the association revealed to its constituents.

Additionally, AHIMA has urged its members and other stakeholders to contact their representatives and senators not for the purpose of supporting the delay but instead of removing the ICD-10 provision from the SGR bill. The association has made the following script available to would-be callers:

Hello Representative XX/Senator XX, my name is XXX and I am a concerned member in your district, as well as a healthcare professional. I am calling to voice my opposition to the language in the SGR patch that would delay ICD-10 implementation until October, 2015. CMS estimates that a 1 year delay could cost between $1 billion to $6.6 billion. This is approximately 10-30% of what has already been invested by providers, payers, vendors and academic programs in your district. Without ICD-10, the return on investment in EHRs and health data exchange will be greatly diminished. I urge you, Representative XX/ Senator XX to oppose the ICD-10 delay and let Speaker Boehner and Senate Majority Leader Reid know that a delay in ICD-10 will substantially increase total implementation costs in your district as well as delay the positive impact for patient care.

Associations such as the American Medical Association (AMA) have asked their members to convince Congress of the need for a timely SGR repeal, with the failure to do by March 31 leading to a 24-percent cut in payments to physicians. But this advocacy does include any mention of the recent inclusion of an ICD-10 delay into the debate over the SGR.




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