After consecutive delays that pushed back implementation by four years, the ICD-10 diagnostic code sets are ready to be released on Oct. 1, 2015. To help health care providers prepare, the U.S. Centers for Medicare and Medicaid Services conducted end-to-end testing for volunteer organizations to measure both their own readiness and the agency's ability to accept the codes.
On Feb. 27, after the testing had concluded, CMS organized a presentation on the testing process and provided guidance on implementation through the Medicare Learning Network National Provider Call. According to EHRIntelligence, physicians had concerns about how the program was handled by CMS.
Working toward readiness
Denesecia Green, deputy director of the National Standards Group, discussed preparation for the new compliance data during the presentation. Providers from all specialties, including medical imaging, have been working toward full ICD-10 readiness to ensure no claims submitted to payers are rejected due to incomplete or incorrect reports. CMS representatives coordinated discussions with physicians to understand what type of support they are looking for during the implementation process.
According to Green, many providers were looking for increased training opportunities to educate their staff about ICD-10 and the steps required to prepare for the compliance deadline. CMS coordinates both virtual and on-site sessions for any clinical employees to attend and runs focus groups on ICD-9 and ICD-10 coding. The agency also developed a website called roadto10.org, which details action plans for readiness.
While CMS stated that the testing period was overwhelmingly successful, multiple providers expressed concerns about the process during a question-and-answer session after the presentation. Although it is important to measure health organizations' readiness, the participants were worried that only 50 volunteers would be chosen by each Medicare Administrative Contractor during every testing week, EHRIntelligence explained.
However, CMS urged the concerned providers to coordinate their own testing periods with clearinghouses, vendors and other associations if they are not selected by an MAC. In addition, there is still the potential for another delay from Congress that pushes ICD-10 even further down the road.
Governing the transition
The ICD-10 timeline is anything but simple, as the deadline was extended by Congress in 2009, 2012 and 2014. While many may have had reservations about the fourth time around, the recent ICD-10 hearing from the House Energy and Commerce's Health Subcommittee quelled any lingering doubts, FierceHealthIT reported.
The proceedings consisted of seven witnesses who offered their own expert insight on ICD-10 readiness, including physicians from several specialties. The majority consensus was that the U.S. health care industry needs to move forward with the code set, as additional delays would only lead to costly, time-consuming problems for providers. For example, Rep. Joseph Pitts (R-Penn.) stressed that ICD-9 is more than 30 years old and lacks the capabilities needed to capture meaningful clinical data.
With legislators largely backing the ICD-10 deadline of Oct. 1, 2015, health organizations can breathe easy knowing that Congress is very unlikely to issue another year-long delay that could have a significant financial impact on countless providers and patients.
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Ronny Bachrach
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