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ICD-10 Coalition Urges Congress to Avoid Additional Delays

By Jennifer Bresnick

Further ICD-10 delays would risk additional disruption and unnecessary costs for the healthcare industry, the ICD-10 Coalition told Congress recently.

The Coalition for ICD-10 has sent a letter to Congressional leaders urging lawmakers not to implement any more delays for the new code set.  After the surprise vote in April pushed the codes back until October 1, 2015, shock and disappointment were pervasive among those who had already mostly prepared themselves for the big switch.  Citing the ongoing costs of retooling ICD-10 transition projects and the desperate need for an expanded diagnosis code set that will foster population health management and more accurate billing, the Coalition stresses the importance of ensuring ICD-10 goes ahead as currently planned.

“ICD-10 implementation delays have been disruptive and costly for all of the coalition members, as well as to health care delivery innovation, payment reform, public health, and health care spending,” states the letter, addressed to leaders of both the House and the Senate. “As you know, significant investments were made by members of our coalition to prepare for the October 2014 implementation prior to enactment of the most recent delay. Many of us had to quickly reconfigure systems and processes that were prepared to use ICD-10 back to ICD-9. Newly trained coders who graduated from ICD-10 focused programs were unprepared to find jobs using the older code set.”

While a recent AHIMA report lowered the American Medical Association’s estimated cost of ICD-10 implementation for small physician practices from a high of $100,000 to around $5,000, the impact of the delay is somewhat harder to quantify.  Some organizations may need to extend educational programs or re-train coders, while others might need to invest in new ICD-10 compliant technologies after making other purchases throughout 2014.

“HHS has estimated the cost of the most recent delay at $6.8 billion; further delays beyond October 1, 2015 range from $1 billion to $6.6 billion in additional costs,” the letter says. “Nearly three quarters of the hospitals and health systems surveyed just before the current delay were confident in their ability to successfully implement ICD-10. Retraining personnel and reconfiguring systems multiple times in anticipation of the implementation of ICD-10 is unnecessarily driving up the cost of healthcare.”

At a Capitol Hill briefing at the end of September, a number of ICD-10 experts argued for the financial and clinical value of the new codes.  Sandra J. Wolfskill, FHFMA, Director Healthcare Finance Policy and Revenue Cycle MAP at HFMA, held up the diagnosis of asthma as an area that will benefit from the specificity of ICD-10.  As opposed to one single asthma diagnosis in ICD-9, the new codes allow for four levels of severity, which will help to provide data on resource utilization and develop risk models for better chronic disease management.

Wolfskill also cited data from a recent HFMA survey that found 71% of organizations believed they would have been ready for the October 2014 deadline, and 77% had already completed ICD-10 testing with their hospital-owned entities.

The Coalition applauded CMS for opening up testing opportunities to the healthcare community in advance of the new 2015 date, and added that “members of our coalition are engaging in significant efforts to identify and educate those in need of assistance to be ready for the 2015 implementation, including payer-provider collaboratives, training and outreach initiatives, and programs to help coders maintain their new code set skills.”




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