Legislation proposed in the House would permit providers to code in either ICD-9 or ICD-10 for half a year after the ICD-10 implementation deadline, now set for Oct. 1.
The bill, Coding Flexibility in Healthcare Act of 2015 introduced by Rep. Marsha Blackburn (R-Tenn.) and co-sponsored by fellow Republican Rep. Tom Price (R-Ga.), a physician, would also require HHS to report to Congress 90 days after implementation of ICD-10 on the impacts the new codes are having on providers, patients and other stakeholders.
The bill has already garnered support from the Medical Group Management Association, a professional association for physician group practice leaders and managers. In a letter to Blackburn and Price, Dr. Halee Fischer-Wright, MGMA president and CEO, said the bill would afford physicians “much needed flexibility and provides a window of time to address inevitable system issues to ensure claims are processed and paid.”
“We appreciate your support for the nation's medical groups and urge the committees to favorably review it and send it to the floor for a vote,” Fischer-Wright said.
The question remains whether a new bill can pass at this stage of the current legislative session—and whether it even needs to pass to be effective.
“There's always time to get a bill through, if they all get on the same page,” said Bruce Hallowell, managing director with consultant Navigant's healthcare practice, which recently issued a white paper on ICD-10 that included a narrowing timeline for legislative intervention.
But Robert Tennant, senior policy analyst at the MGMA, said a strategy often employed in Washington goes “beyond simply hoping a bill is passed into law.”
Other ICD-10 legislation by Reps. Diane Black (R-Tenn.) and Gary Palmer (R-Ala.) called for a grace period for non-specific ICD-10 codes to be paid, Tennant said. And last week, the CMS, joining with longtime ICD-10 opponent American Medical Association, in an unusual news release said the wiggle room had been granted.
Pending legislation,Tennant said, can “send a message that Congress is watching.”
Dual coding would ensure that providers won't go out of business if they try and fail to send ICD-10-coded claims or have a billing vendor that hasn't upgraded its system, Tennant said. The approach called for in the Blackburn/Price bill, he said, “is exactly the same policy CMS instituted with 5010 in 2012.”
Back then, HHS set a Jan. 1, 2012, deadline for upgrading to the ASC X12 Version 5010 messaging standard for medical claims. But because of difficulties in installing Version 5010-ready software, providers were having trouble getting paid, so HHS twice delayed enforcement deadlines.
“We're not breaking new ground here,” Tennant said.
