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.
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Focus on Technology: Preparing your practice for ICD-10




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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Health Reform to 2014 and Beyond or Back to the Future

The More You Understand About the 2014 Changes,  The Better.

If you had not noticed.

I am retired from clinical practice, and  admit I miss seeing patients.  My career goals have changed as some of you have noticed.

During the last decade I became interested in health information technology and set out to communicate with fellow professionals.  Readers of Health Train Express and it's predecessor will see an evolution, beginning with electronic medical records, health information exchange, health reform, mobile health applications, remote monitoring, and telehealth. They all serve to integrate our health communications for providers and patients.

During the last 12 months I was diverted by the Affordable Care Act and  the promises of Accountable Care Act. The potential for these new paradigms are great, however the day to day activities of providers and hospitals will  increase their load, and without additonal reimbursements. Providers have been expected to make huge capital outlays for health IT, design,implement and use these new systems.  They are directed at reductions in reimbursements to allow the large growth in patient access.  i doubt whether there will ber an actual decrease in the gross outlays for health care.  However during the past two years there have been reports of a decrease in the rate of growth.

There are some key actions to implement changes:  These webinars are designed to address specific areas that will require action.

Understanding Payment Reform - Beyond Fee For Service 

In the past decade there were some pre-paid and capitated models. The new paradigm is to approach payments connected to outcomes.  How they will be measured is open to great debate, and the subject should be addressed actively and with transparency before changes are made to avoid a catastophe such as the Health.gov benefit exchanges.  Some of these issues may be addressed by a 'global fee to hospitals and providers and/or medical groups as part and parcel of integrated medical systems.

Understanding The 2014 EHR Incentive Program 

The webinar addresses objective information for non-acute providers,practice and clinics on how to prepare for 2014 changes to the CMS EHR Incentiviei Programs.

An ICD-10 GEMS Crosswalk Overview

GEMS is a term which most providers are not familiar. CMS on it's web site offers these white papers. 

• 2013 General Equivalence Mappings - Diagnosis Codes and Guide [ZIP, 583KB]
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     The compressed zip files contain 3 white papers.

     The Dxgem file addresses specifics of conversion from ICD9 to ICD10.

MDs Everywhere's Vice-President of Development, Doug Salas explains the impact of 14,000 ICD codes expanding to 70,000 will have on documenting

Understanding HIPAA Requirements and Safety Measures 

HIPAA has been around since the mid 1990'. Providers have always known the standards of ehtical private confidentiality.  HIPAA was designed for others, institutions who deal with large amounts of patient health and financial data.  Penalties and fines are impressively high and the law has been enforced agains several large hospitals and other custodians of health records.

Recording and Archived:  (In case  you cannot attend the webinar at it's schedule time) At the time of registration you will receive a link and a date, which can be downloaded to an Outlook  .ics file.

All of the webinars will be archived for later viewing