Tuesday, June 9, 2015

ICD 10 Getting Ready for October 1, 2015





Much confusion and hand wringing are occurring in regard to the deadline for ICD 10.  CMS, providers and organized medicine (American Medical Association) AMA  The AMA has asked for postponement previously.

Past deadlines were as early as October 2013, followed by a CMS reversal postponing the date to October 1, 2014

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The latest date posted by CMS is October 1, 2015. Despite some success in Congress repealing the SGR (sustainable growth reduction), CMS remains adamant about the date.

Congress intervened to delay the original date of October 14, 2015.  CMS was adamant about keeping October 1, 2014, as the compliance date. However, Congress passed H.R. 4302, "Protecting Access to Medicare Act of 2014" in March. The bill included this statement:
    • The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD–10 code sets as the standard for code sets under section 1173(c) of the Social Security Act (42 U.S.C. 1320d–2(c)) and section 162.1002 of title 45, Code of Federal Regulations.


President Obama signed the bill into law April 1 and as a result, HHS was forced to move the ICD-10 implementation date.

HHS first stated October 1, 2015, as the new implementation date in the IPPS proposed rule, released April 30. In several places in the proposed rule, HHS referred to October 1, 2015, as the ICD-10 implementation date.  One day later, CMS issued this statement:
    • On April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93) was enacted, which said that the Secretary may not adopt ICD-10 prior to October 1, 2015. Accordingly, the U.S. Department of Health and Human Services expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through September 30, 2015.



    Latest from the AMA

    The AMA appears to carry little influence with congress. The AMA is considered a 'special interest group" and is placed in the special category of most lobbyists. The AMA also carries less and less influence with members, a shrinking minority of physicians (unfortunately) Most of the time decisions are diluted by the very hierarchical structure of AMA governance. Compromise at the top waters down whatever the strong intent of the membership.  The AMA is better at publishing educational material and/or selling insurance as a front-man for a number of insurers. Today's world of Internet communication, openness and transparency leaves open to question, why go to AMA meetings, and why aren't they carried online via webinars and/or YouTube videos ? The AMA is fossilized.



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