Physician groups earlier this month won a much sought after two-year delay in implementing the International Classification of Diseases, 10th Revision, coding system, although they may have to keep the cork in the bottle for a few more weeks. HHS final rule for transitioning to the ICD-10, which was published in the Jan. 15 Federal Register, pushed back the compliance deadline to Oct. 1, 2013. The proposed rule, which was published last August, called for an Oct. 1, 2011 compliance deadline.
However, the rules effective date of March 17 could be pushed back as the new Obama White House put on hold any new or pending regulations issued under the previous Bush administration.
A memorandum released by White House Chief of Staff Rahm Emanuel has put a hold on all regulations that have either not been published or those that have not yet taken legal effect, a CMS spokesman says. Although the CMS has yet to produce a list of the affected regulations, its likely that at least four recent rulemakings could be put on hold, including HHS final ICD-10 rule, the spokesman says.
Still, the two-year delay was welcome news to many in healthcare.
George Arges, senior director of the health data management group at the American Hospital Association, saysthe deadline was a year later than the association had requested, but with the slowing economy, I think were happy with the timeline. I think the time frame that was put forward was aggressive, but realistic. Now that the ICD-10 deadline is fixed, people can put money into IT and components, he said. Although the compliance deadline has been pushed back, the long-awaited andby all accountsexpensive and difficult transition to the ICD-10 code sets has officially begun.
According to an estimate of costs and benefits included in the proposed rule, implementing the changes will cost nearly $3 billion. Those costs will begin to occur in 2011 and run through 2017. But HHS estimates the total benefits of the conversion at $4.5 billion, accruing between 2015 and 2025.
The ICD-10 conversion rule came in a 185-page amendment to the rules covering transactions and code sets under the 1996 Health Insurance Portability and Accountability Act. It noted that most commenters disagreed with the earlier compliance date, stating that it did not provide adequate time for industry to train coders and complete systems changeovers and testing.
In companion rulemaking, HHS also posted a final rule covering an upgrade from the X12 Version 4010 data-transmission standards in current use to Version 5010, which is a prerequisite to an ICD-10 conversion because those codes are larger and more complex than ICD-9 codes.
The proposed rule on 5010 also released last August called for an Oct. 1, 2010 deadline for conversion to the 5010 transactions standards. In the final rule, HHS settled on Jan. 1, 2012, for compliance with the 5010 standards.
These regulations will move the nation toward a more efficient, quality-focused healthcare system by helping accelerate the widespread adoption of health information technology, Mike Leavitt said while he was still HHS secretary. The greatly expanded ICD-10 code sets will fully support quality reporting, pay-for-performance, biosurveillance and other critical activities. The updated X12 transaction standards, Version 5010, provide the framework needed to support the ICD-10 codes.
The American Health Information Management Association has been stumping for the ICD-10 upgrade for 15 years and the National Committee on Vital and Health Statistics, the official IT advisory panel to HHS under HIPAA, first recommended the upgrade in the early 1990s, according to Sue Bowman, director of coding policy and compliance for the Chicago-based association of medical records professionals.
AHIMA caught flak from several directions for its stance in support of the original ICD-10 deadline, but Bowman sayseven with the delayed start, Were just happy finally having a rule out and being able to move forward after 15 years working on this.
Bowman saysthat the upgrade requirement fits very nicely with a proposal by President Barack Obama to dramatically boost federal support for spending on healthcare IT, with numbers being bandied about in the tens of billions of dollars. Providers need to make sure the 5010 and ICD-10 upgrades are discussed with their IT vendors, she says.
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