CMS finally pins down new official ICD-10 deadline

As expected, the Centers for Medicare and Medicaid Services (CMS) finally announced late Thursday that Oct. 1, 2015, will indeed be the new transition date for the International Classification of Diseases 10th Revision (ICD-10) coding system in healthcare claims.

Up until late March of this year, CMS officials had steadfastly reaffirmed that there would be no more delays in implementation of ICD-10 coding and that October 1 of this year was the absolute final final deadline. However, that changed when Congress passed the Protecting Access to Medicare Act — a bill to delay the mandatory application of the much maligned sustainable growth rate (SGR) formula to Medicare physician payments.

Since physician groups, including the powerful American Medical Association, had made getting rid of the SGR once and for all their number one legislative issue for 2013 and early 2014, legislators tucked a one-year delay in ICD-10 implementation into the bill as a way to give physician groups at least something that they were asking for at the same time as they denied their top policy priority with passage of yet another temporary SGR fix.

Oct. 1, 2015, is the absolute soonest the switch to ICD-10 coding can be made under the law and healthcare industy stakeholders have been urging CMS to finalize that as the date for nearly four months. In April, a broad coalition of nine major industry stakeholders wrote to CMS about the issue, pointing out that each additional day that ICD-10 is delayed only adds to costs and disrupts healthcare reform. In addition, the delay has left many aspiring health IT and coding experts in limbo as programs that educate new coders and health information management professionals had already switched to only teaching ICD-10 coding, the coalition said.

“[Coalition] organizations have already expended an enormous amount of time, effort and resources in preparing for the transition to ICD-10 in accordance with the original timeline given by [the U.S. Department of Health and Human Services] … A 30 percent cost increase due to a one-year delay is consistent with the experience and observations of the coalition members,” the April letter addressed to CMS Administrator Marilyn Tavenner stated. It was signed by the Advanced Medical Technology Association (AdvaMed), the American Health Information Management Association (AHIMA), America’s Health Insurance Plans (AHIP), the American Medical Informatics Association (AMIA), the BlueCross BlueShield Association, the College of Healthcare Information Management Executives (CHIME), the Health IT Now Coalition, the Medical Device Manufacturers Association (MDMA) and 3M Health Information Systems.

In the press release announcing the new deadline, CMS offered assurances that it and other payors would be ready and that it expected that the new deadline would give healthcare providers ample time to get ready as well. “CMS has implemented a comprehensive testing approach, including end-to-end testing in 2015, to help ensure providers are ready. While many providers, including physicians, hospitals, and health plans, have completed the necessary system changes to transition to ICD-10, the time offered by Congress and this rule ensure all providers are ready,” the CMS release assured.