ICD-10 Implementation Delayed Until October 2015

On April 1, President Obama signed into law H.R.4302  the Protecting Access to Medicare Act of 2014.  This bill was introduced to the House of Representatives on March 26, with the primary intent of repealing the 1997 budget cap calculation called the Sustainable Growth Rate (SGR) and replacing it with a .5 percent increase for each of the next five years, during which Medicare will transition to an alternate payment model.

The law now extends Medicare’s SGR current rate to April 15, 2015 and delays other Medicare deadlines. The law also postpones ICD-10 implementation until October 1, 2015, and restricts the Centers for Medicare and Medicaid Services (CMS) from acting without congressional approval.

Primary arguments cited for delaying the ICD-10 implementation included lack of readiness surrounding clinical documentation, vendor solutions, and systems testing.  With this in mind, a huge opportunity has now opened up for those who were not previously prepared.  Sufficient time now exists for adequate ICD-10 implementation and training.

The delay of ICD-10 was not a primary consideration in passing the law.  According to Kelly Driscoll, Director of Business Development at e2o Health , “It took the Senate nearly five hours Monday to debate and approve a bill that would temporarily fix the SGR and also delay ICD-10 one year…During that time not a single senator made mention of the ICD-10 provision included in the bill…”

Regardless of whether the intent of the enacted law was to delay ICD-10 implementation, ultimately, all providers and hospitals will need to convert to the new coding system.   Many providers, clearinghouses and payers have already begun implementation.  Providers need to take advantage of the increased time frame and review their implementation plans and training schedules.   If ICD-10 implementation and training plans are not in place, now is the time to make them.  

Nancy Clark is a Manager in the Health Care Services Group. Her expertise focuses on coding and documentation audits, which includes chart review and report compilation.

* Required