ICD-10 Will Not Be Delayed, Now What?

The week of March 3 is the Centers of Medicare and Medicaid (CMS) national testing week for ICD-10 implementation, and it promises to be busy as CMS Administrator Marilyn Tavenner announced at the Healthcare Information and Management Systems Society (HIMSS) 2014 meeting that there will be no change in the October 1 deadline for the switch to ICD-10.

According to a February 27 update on the testing plans, CMS promises that the Medicare Administrative Contractors for Part A and Part B providers and suppliers will have extra staff on hand during the testing week to handle calls for help. Test claims will receive acknowledgement that the claim was accepted or rejected in the system. However, the system will not confirm payment or offer advice on how to get a claim paid. It also cautioned providers participating in the test not to use dates of service that would reflect the October 1 transition as the system is not set up to handle theoretical claim dates that occur in the future.

The lack of testing of the whole ICD-10 claims process all the way through to payment of claims was a key concern raised by U.S. Senators and physicians Tom Coburn, M.D. (R-Okla.), John Barrasso, M.D. (R-Wyo.), John Boozman, O.D. (R-Ark.), and Rand Paul, M.D. (R-Ky.) in a letter to Tavenner last week. They noted that “given the size and scope of the potential transition to ICD-10, the brevity and limited scope of this test is worrisome.”

Their bill, the Cutting Costly Codes Act (S. 972), which would prohibit HHS from moving forward with the ICD-10 transition, is unlikely to pass, so providers should not count on another delay.

According to CMS’s website section aimed at helping providers transition to ICD-10, providers should be actively testing their systems by this point. A survey conducted by the American Hospital Association last year found that most hospitals report that they will be ready for the transition. However, the Medical Group Management Association found that this was not so for many physician practices in its 2013 survey on ICD-10 readiness.

In addition, a report issued by the American Medical Association last month found that the transition to ICD-10 will likely cost many times the original estimate of the cost made in 2008 because of increased regulatory burden on providers in the past five years. For a large practice, the cost could now be as high as $8,018,364, the report found.