With the hope of finally laying to rest a long-running debate, the U.S. Department of Health and Human Services issued a final rule yesterday that officially delays the compliance date for implementing the International Classification of Diseases, 10th Edition medical data code sets. The compliance date will be pushed back one year, from October 1, 2013 to October 1, 2014. HHS said that the delay would allow health care organizations adequate time to get ready for the changeover (McKinney, Modern Healthcare, 8/24).
“By allowing more time to prepare, covered entities may be able to avoid costly obstacles that would otherwise emerge while in production,” HHS said in the rule.
In 2009, HHS released a proposed rule that would make ICD-10 the standard code set for identifying diseases and procedures on health care transactions. The switch from the previous version – ICD-9 – is a massive undertaking, with health care providers and insurers having to change from about 14,000 codes to over 69,000 codes. The HHS has already delayed the compliance once, having originally proposed an October 1, 2011 transition date.
Last fall, the American Medical Association vowed to “work vigorously” to stop the transition, citing concerns over competing regulatory changes currently underway, the cost burden on physicians, and doubts over the benefits of ICD-10. In January, the AMA sent a letter to House Speaker John Boehner, asking Congress to halt implementation of the code sets and give the industry time to find a more suitable alternative to ICD-10.
Bowing to the pressure, the HHS released a proposed rule in April that announced the implementation date would be delayed one year, in response to providers’ concerns that they would not be able to meet the initial deadline. Public comments submitted in response to the proposed rule varied – many organizations believed the one year delay was sufficient while some organizations – namely the AMA – continued to push for a longer delay, possibly canceling the transition completely and waiting for the next version. The World Health Organization is responsible for developing ICD code sets and is expected to have a draft version of ICD-11 ready as early as 2015.
The final rule, which also includes the establishment of a unique health plan identifier for all insurers, is now the official – and hopefully last – word on the subject. The HHS says that the identifier, as well as administrative simplification regulations included in the healthcare reform law, will save the industry an estimated $6 billion over the next 10 years.
“These new standards are part of our efforts to help providers and health plans spend less time filling out paperwork and more time seeing their patients,” said HHS Secretary Kathleen Sebelius.
With the final word coming from the HHS, health care organizations can focus once again on the work to be done. Many organizations were already far along in the transition process and the delay means added costs – anywhere from $1 billion to $6 billion. However, the HHS estimates the cost avoidance of the delay to be approximately $3.6 billion to as much as $8 billion. The American Health Information Management Association has been a strong proponent of ICD-10 and has encouraged providers to remain steadfast even under uncertainty.
“We realize that a few are still apprehensive about the implementation process, and that is why AHIMA remains committed to assisting the healthcare community with its transition to a new code set that will lead to improved patient care and reduced costs,” said AHIMA CEO Lynn Thomas Gordon.
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