Several hospital associations, characterizing the twice-postponed implementation of the ICD-10 diagnostic coding set as “disruptive and costly,” are urging House and Senate leaders to avoid any further delays.
The nation’s leading hospital associations want the lame duck Congress to avoid further delays of the Oct. 1, 2015 implementation date for the ICD-10 diagnostic coding set.
In a letter to House and Senate leaders in both parties, the American Hospital Association, America’s Essential Hospitals, the Association of American Medical Colleges, Catholic Health Association of the United States, and three other hospital associations said the “implementation delays have been disruptive and costly for hospitals and health systems, as well as to healthcare delivery innovation, payment reform, public health, and healthcare payment.”
“We urge Congress to avoid any further delays of this needed coding update. ICD-9 is outdated and ICD-10 is needed to keep up with advances in medicine and ensure accurate payment.”
The hospitals’ plea for no more delays comes just days after physicians associations in Texas and New York urged their members to press House Republican leaders to delay ICD-10 implementation until 2017.
The twice-delayed ICD-10 implementation was supposed to have taken effect on Oct. 1, 2014. Last spring, however, Congress slipped a one-year delay for the coding set into a 121-page bill that postponed for a 17th time Medicare reimbursement cuts mandated under the Sustainable Growth Rate funding scheme.
The Medical Society for the State of New York’s form letter to Republican leaders suggests that they recycle last spring’s tactics and “have this added to a must-pass piece of legislation” before the lame duck session of Congress adjourns this month.
ICD-10 implementation was announced in 2009 and scheduled initially for 2013. The United States is the last industrialized nation in the world that still uses the ICD-9 code set, which was launched in the 1970s.
Physicians associations have a long list of complaints against ICD-10. They say that ICD-10’s 68,000 diagnostic codes—five times more codes than in ICD-9—are too complicated and too expensive and do little if anything to improve care delivery.
They also contend that ICD-10’s linkage to Medicare billing systems has not been sufficiently tested and could mean extensive delays in payments if unforeseen problems arise with the code set.
In addition, the physicians’ associations say that physicians’ offices are already struggling to comply with other expensive, complex, and time-consuming federal mandates, such as meaningful use for electronic medical records, and quality reporting.
The hospital groups said in their letter to Congress that they’ve already spent billions of dollars preparing for implementation of ICD-10 and that the most-recent one-year delay “added billions of dollars in extra costs.”
“Many of our members had to quickly reconfigure systems and processes that were prepared to use ICD-10 back to ICD-9,” the letter said. “Newly trained coders who graduated from ICD-10 focused programs were unprepared for use of the older code set and needed to be retrained back to using ICD-9. Further, training of existing coders needed to be repeated given the one-year delay. This results in a doubling of costs that are not productive. A further delay would only add additional costs as existing investments would be further wasted and future costs would grow.”
The hospitals said they’re working with the Department of Health and Human Services “to ensure a smooth and successful transition in 2015.”
“We support the recently announced end-to-end testing dates issued by Centers for Medicare & Medicaid Services and are encouraging all of our members to participate in these opportunities,” the hospital associations said.
“In addition, our hospital members are engaging in significant efforts to be ready for the 2015 implementation, including supporting their affiliated physicians, working with their payers, and conducting training and outreach initiatives for clinicians and coders.”