Anesthesia Management: Doctors Seek Another ICD-10 Delay

The twice-delayed ICD-10 implementation was supposed to have taken effect on Oct. 1, 2014. Now physicians groups in two states are asking members to implore their representatives in Congress for a two-year postponement.

Physician associations in Texas and New York are urging their members to press the lame duck Congress to delay ICD-10 implementation until October 2017.

“It’s imperative that you contact your representative today and explain how you cannot afford the cost and disruption of ICD-10 implementation to your business, especially now, when you are buried in myriad other bureaucratic burdens,” Texas Medical Association President Austin I. King, MD, said in a letter to members.

“Take action now. It’s easy and doesn’t require much time. Just cut and paste the letter below onto your personal stationery, then send it to your representative by mail or by fax. It’s important the letter is on your personal stationery. Feel free to add your own personal reasons why ICD-10 is not a good idea. Explain how implementing ICD-10 now will affect your practice and will take even more of your time away from patient care.”

The Medical Society of the State of New York asked its members to sign the society’s form letter and send it to House Speaker John Boehner, (R-OH), and other senior Republican House leaders.

“The onerous penalties tied to these mandates add to the hysteria that is running through physicians’ offices and is generating many early retirements,” the society’s letter to Boehner states. “We are asking for you to please work with Chairman of the House Energy and Commerce Committee, Fred Upton and Chairman of the Rules Committee, Pete Sessions to have this added to a must pass piece of legislation during the upcoming Lame Duck Session in 2014. Both Chairmen have been fully briefed on the importance of this request.”

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.

This most-recent call by the New York society to “have this added to a must-pass piece of legislation” suggests that sympathetic lawmakers may reuse last spring’s 11th hour tactic before the lame duck session of Congress adjourns this month.

This time, however, ICD-10 advocates say they won’t be caught flat-footed.

“We are realistic in knowing that with the lame duck Congress that something might happen, so we are gearing our members up,” says Lynne Thomas Gordon, CEO of the American Health Information Management Association.

The switch to ICD-10 was announced in 2009. “My heart goes out to the physicians because all of this change is tough, but we do feel like they have had plenty of time to get ready, and they still have almost another year,” Gordon says.

Hospitals and other providers who were ready for the 2013, 2014, and now 2015 implementation dates are being unfairly penalized by those who haven’t, she says.

“It’s tough for us because it’s a start/stop/start/stop process,” she says. “Everybody has trained their staff. They’re reconfiguring their systems and doing what they have to do in good faith to get ready and then it comes to a screeching halt.”

Chantal Worzala, director of policy for the American Hospital Association, says the AHA supports “maintaining the Oct. 1, 2015 transition date.”

“Further delay would be expensive and penalize hospitals that have been diligently preparing for the transition. ICD-9 is outdated. We need ICD-10 to accommodate medical advances,” Worzala said via email Thursday.

Michael O’Rourke, CIO at Englewood, CO-based Catholic Health Initiatives, says the 2015 implementation date should remain in place.

“Catholic Health Initiatives has been working through those issues for the past two years. The cost and complication of this project and the continuous delays have become a significant burden,” O’Rourke said via email Thursday.

“We understand why [physicians’ associations] and others would seek to postpone the conversion. The reality for Catholic Health Initiatives is that, like many other healthcare organizations, we have spent tens of millions of dollars preparing for ICD-10 and millions more adjusting to the delays. Further delays will materially increase the cost of ICD-10 for the organization.”

The American Medical Association has not placed a high public priority on delaying ICD-10, but the nation’s largest physicians’ association also was not disappointed when the diagnostic coding set was delayed for another year last spring.

The AMA said this week, however, that the ICD-10 delay was largely an issue for state medical associations.

“The AMA’s number one priority for the lame duck session is fixing the sustainable growth rate and that has been the focus of our recent grassroots and lobbying efforts,” AMA said via email. “The AMA will continue its work on ICD-10 when the new Congress convenes. The results of end-to-end testing will be pivotal and a GAO report is also expected to be released next year.”