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The Job Killing ICD-10 Delay Program

I thought I’d offer a little of my own spin in the headline since those in DC only like to read spin. Unfortunately, I don’t think those in DC will really hear the message and I believe the ICD-10 delay will be passed. I still think that most of congress is voting on the SGR part of the bill and not the ICD-10 delay, but this vote will support the many doctors who don’t want ICD-10 implemented at all ever. This is a strong and large group of doctors that congress does care about.

However, I can’t help but highlight the thousands of coders that will be affected as well. In the link above I quoted a coder who’d paid for the ICD-10 course and now it’s wasted money (and it’s not like coders have a lot of excess income).

Add to that story this story from an educator who switched their educational program to ICD-10. If the ICD-10 delay happens, then all of those newly trained ICD-10 professionals won’t be able to find a job. Read more below from Kelly Fast, MS, RHIA, CMT:

I am a program director of an HIT program in candidacy with CAHIIM. The program began in the summer of 2012. We anticipated we would have graduates this year, the year of the implementation. We went with the assurances from HHS that there would not be another delay. All of our coding curriculum has been taught with ICD-10 (with a nod to ICD-9 from a historical perspective). We now have graduates. As we are all aware, it is so difficult for new graduates to secure coding positions. This delay, if it happens, will definitely not be a competitive advantage for our students! We went with the implementation date sticking and the training in ICD-10 being a positive thing for our students in the workplace. It is so disappointing that this is even being considered.

From the perspective of how many students this will affect nationally — there are over 17,000 students in CAHIIM accredited health information programs.

I think of our students — our job is to prepare them as best we can for the workplace! Are our students going to be given a break on their student loans until October of 2015? I think not. Are our students going to have their loans forgiven when the skill they have gone into debt to learn is a distant memory to them, due to no fault of their own? Again, I think not.

To all students — keep practicing, practicing! At some point the new classification system will be implemented and you will have the opportunity to shine!

So far, AHIMA is keeping the implementation date for the RHIT exam with ICD-10 the same. That is one silver lining for the students. But, yes, this looming delay will have far, far reaching effects. We will be evaluated as a program as to how many of our students pass the exam. So thank you AHIMA for so far not pushing out the date of the switch of the exam from 9 to 10 for the RHIT. Also, we will be evaluated on how many of our students are able to become employed in healthcare. That one will definitely not be helped by any delay.

Also, we had scheduled an area ICD-10 training for next month on our campus. That will be postponed if the Senate passes this bill intact. Just the time and effort in getting all of the leg work done for that has been a lot, and it will all have to be repeated. When you are coordinating large gatherings of people, it isn’t as simple as reworking the dates. When I think about multiplying that effort for training rescheduling over and over for organizations all across the country…wow.

Here’s another personal story that illustrates the personal impact of the ICD-10 delay:

I’d like to chime in as a student about to graduate from an HIT associate degree program. Thank you for all your posts. Like all of you I am shocked by this turn of events. I am a single mom who enrolled in this program after my divorce which pulled the rug from under me and put my kids and I out of our home and, after being a stay at home mom, left me with no income. I’ve worked hard, sacrificed, and have been excited to enter this field that would be a perfect fit for me and would allow me to get back on my feet. I am only trained in ICD10 since the college I attend stopped teaching 9 because of the switch that was supposed to happen this year. I was planning on getting certified and entering the workforce this fall. I need to start earning an income or we could be out on the street. Where will this leave people like me? Congress apparently could care less how they mess with peoples lives. I too have contacted my senator. I pray they will hear us.

Unfortunately, I’m afraid the Congress looks more at the macro and political impact of this bill instead of the personal impact this will have on many people. I hear we’ll have to wait until Monday for the Senate to vote on the bill.

March 28, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

BREAKING: Possible ICD-10 Delay … Again – AHIMA Call for Action

UPDATE: It looks like this bill has passed the house with a voice vote. I believe it still needs to be passed by Congress and not be vetoed by the President.

UPDATE 2: Late on 3/31/14, the Senate passed the bill which delays ICD-10 by a vote of 64 – 35. Barring a veto from the President, the bill will go forth and the ICD-10 implementation date will be moved to October 1, 2015. All of the discussion for the bill was around the SGR fix with no conversation around the ICD-10 delay. It’s unlikely that the President would even consider a veto of this bill.

A bill that would adjust the SGR (Sustainable Growth Rate) was introduced to the US House and Senate with a 7 line provision that would effectively delay ICD-10 another year until October 1, 2015. Here’s the section of the bill:

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 13 Social Security Act (42 U.S.C. 1320d–2(c)) and section 14 162.1002 of title 45, Code of Federal Regulations.

This is really interesting news after the discussion we’ve been having in this Why ICD-10? post. No doubt there are a lot of strong feelings on both sides. Some really want a delay and some really want it to keep going forward. I wonder if Congress will get a mix bag of calls from both sides of the debate which won’t sway them either way.

AHIMA is definitely on the side of those calling for no delay to ICD-10. They sent out the following call to action to their community:

Call Congress Now to Request Removal of Delay Provision

Again, this bill is expected to go to the House floor tomorrow for a vote. AHIMA urges members and other stakeholders to contact their representatives in Congress today and ask them to take the ICD-10 provision out of the SGR bill.

Go to our website now and use your zip code to look up phone numbers for your representatives and senators in Congress. http://capwiz.com/ahima/callalert/index.tt?alertid=63161891

Phone Script Available Below for Use in Contacting Your Legislator:

“Hello Representative XX/Senator XX, my name is XXX and I am a concerned member in your district, as well as a healthcare professional. I am calling to voice my opposition to the language in the SGR patch that would delay ICD-10 implementation until October, 2015. CMS estimates that a 1 year delay could cost between $1 billion to $6.6 billion. This is approximately 10-30% of what has already been invested by providers, payers, vendors and academic programs in your district. Without ICD-10, the return on investment in EHRs and health data exchange will be greatly diminished. I urge you, Representative XX/ Senator XX to oppose the ICD-10 delay and let Speaker Boehner and Senate Majority Leader Reid know that a delay in ICD-10 will substantially increase total implementation costs in your district as well as delay the positive impact for patient care.”

My question is if they delay ICD-10, will ICD-10 ever happen? A strong argument will then be made to move straight to ICD-11. Although, all of those people who spent hours coding their applications for ICD-10 won’t like that change.

Like many people, I’m somewhere in the middle on this. Some certainty would be the most valuable thing. I’m certain that HHS wants ICD-10 to go forward. That’s certain. However, congress may have different ideas.

March 26, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

ICD-10 Frequently Asked Questions (Including Update on Revised CMS-1500 Form)

The following is a guest blog post by Dana Deardorff.

Are you concerned about the upcoming changes in coding? The following are answers to frequently asked questions that will help you prepare for the changes ahead. Please note the deadline for the first significant change is April 1, 2014.

What does ICD-10 stand for?

ICD-10 is an abbreviation. It stands for the International Classification of Diseases, 10th Revision. It is used when referring to either the Clinical Modification (ICD-10-CM) or Procedure Coding System (ICD-10-PCS).

How will ICD-10-CM be used?

ICD-10-CM will replace ICD-9-CM codes, Volumes 1 and 2. It will be used when reporting clinical setting diagnoses.

How will ICD-10-PCS be used?

ICD-10-PCS will be used by hospitals to report inpatient procedures.

Who has to convert to ICD-10?

Health care providers, clearinghouses, payers and physicians all are required to convert to ICD-10. This is not optional and includes any HIPAA covered entity.

What will happen if I don’t convert to ICD-10 by the October 1st deadline?

If you submit ICD-9 codes after October 1, 2014, those transactions will not be accepted. Those transactions will be denied. This will cause you to lose out on reimbursements. You may need to apply for a line of credit to prepare for cash flow disruptions that may occur due to noncompliance problems. This will help protect you from negative impact if your medical practice partners do not convert to ICD-10 in time.

What is the deadline for the ICD-10 conversion?

The deadline is October 1, 2014.

What is this April 1, 2014 deadline I keep hearing about?

The April 1 deadline is for the revised CMS-1500 form used for submission of paper claims. The CMS-1500 form is an intricate part of the ICD coding system. The new form (version 02/12) is replacing version 08/05. As of April 1, 2014 providers need to use version 02/12 of the CMS-1500 form. The old form will no longer be accepted.

How is the revised CMS-1500 form tied into the ICD-10 transition?

Physicians will notice that the revised CMS-1500 form provides fields for the new ICD-10 codes. However, your payors may not have made the transition from ICD-9 to ICD-10. Physicians should use ICD-9 codes until you have confirmed that the payor has made the transition to ICD-10. After October 1, 2014, your payors should have all made the transition to ICD-10, and you should be able to use the new codes from that date forward.

What is different about the revised CMS-1500 form?

The revised CMS-1500 form:

* Provides fields and indicators for both ICD-9 and ICD-10 codes

* Provides documentation space for up to 12 diagnosis codes

* Offers qualifiers to aid in the identification of provider roles in the furnishing of services

* Uses letters instead of numbers as diagnosis code printers

You will want to upgrade your practice management software or order 02/12 forms immediately if you have not done so already. Discard any 08/05 forms after April 1, 2014.

When should physicians start using the revised CMS-1500 form?

Providers can start using the revised form on January 1, 2014, but all providers must switch to using the revised form as of April 1, 2014. Your (PM) Practice Management/EMR/EHR practice vendor can help you determine what you need to do to remain in compliance as you transition to ICD-10.

About Dana Deardorff of MediPro
MediPro is a full-service medical billing software company offering practice management (PM) software, electronic health records (EHR) and electronic medical records (EMR) from McKesson and IMS.

Since 1995, MediPro, Inc. has been a nationally recognized, award-winning medical billing software company offering practice management systems and electronic health record solutions. MediPro’s mission is to deliver and support integrated solutions to the healthcare community. MediPro recognizes the need for a comprehensive, interactive and cost-effective suite of applications that are customized to address the specific needs of healthcare offices.

March 24, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

ICD-10: How Healthcare is Affected – Twitter Chat Topics #KareoChat

ICD-10 Twitter Chat

As the beautiful image above shows, this Thursday at 9 AM PST I’ll be hosting the #KareoChat. If you’ve never participated in a Twitter chat before, it’s really easy. Just click this link and follow along. You can also join the conversation by creating your own tweets with the hashtag #KareoChat.

The topic for this week’s #KareoChat is ICD-10 and the impact of ICD-10 on healthcare. Here are the topics we’ll discuss over the hour:
1. What have you done to be ready for ICD-10?

2. Which parts of the healthcare ecosystem are you most afraid won’t be ready for ICD-10? Why?

3. What will be the damages if we’re not ready for ICD-10?

4. Are you looking for any ICD-10 benefits beyond just maintaining current reimbursement?

5. Should ICD-10 be delayed again? Why or why not?

I look forward to participating in this ICD-10 focused #KareoChat and I hope many of you can join in as well.

March 11, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Cool is Great, but ICD-10 Is About Payment

I got the following email from a practice manager:

But here is a monster of a question for EMR/EHRs: In 510 days, ICD-10 and its 70,000 plus codes (as opposed to ICD-9′s 14,000 codes) will be on the necks of providers. How will the software handle that? It will have to keep both sets available, because old claims will still be under that system, and may even have to provide a “translator” function from one to the other. Not just a crosswalk, a decision rubric.

This is how the money gets made, and everyone wants to be paid. Cool may be awesome, but payment…well, that’s serious.

As my programmer daughter says, this is what computers do best, but a human has to program it to do that.

This comment is a really interesting one and reminds me of the hospital administrator I was with recently who talked about being overwhelmed with the administrative. ICD-10 is an example of the administrative that can be overwhelming and could have serious financial consequences if not dealt with appropriately.

Plus, the above comment highlights how many practices will be at the mercy of the EHR and other software programmers when it comes to ICD-10. I agree that ICD-10 won’t be an issue for many as long as the programmer does a good job implementing it. In fact, this is why the concept of dual coding ICD-10 is so important. However, as the linked article discusses, that’s not likely an option for a smaller clinic.

Either way, I’m interested in the core idea of being distracted by the shiny things so we miss out on the serious ones.

May 8, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

ICD-10 Delay Finalized with New Unique Plan Identifier

Another big week for healthcare IT and HHS. First, we got the meaningful use stage 2 final rule and now we have the official ICD-10 delay (See our previous post about the proposed ICD-10 delay). Here’s a quote from the announcement:

By delaying the compliance date of ICD-10 from Oct. 1, 2013 to Oct. 1, 2014, we are allowing more time for covered entities to prepare for the transition to ICD-10 and to conduct thorough testing.

This will be a welcome announcement for many in healthcare. Edifecs sent me the following comment about the delay which I think sums up most people’s feelings.

Edifecs commends HHS for finalizing its ruling on the ICD-10 one-year delay. We believe HHS has made the right decision and that a delay of this length strikes a fair compromise in meeting the needs of those healthcare entities that have already started down the ICD-10 path and those that have failed to either begin or show much progress. This one-year delay will give more time to those who need it and will also help those who were on track avoid the excessive costs an even longer delay would have created. Edifecs is encouraging its customers, and the entire healthcare industry, to continue moving forward with their ICD-10 implementations in order to meet the mandate ahead of schedule or on time.

That’s a pretty good word of caution. 2 years seems pretty far away, but that time will pass quickly.

Bigger news might even be the New national unique health plan identifier (HPID) that is being put in place. Sebelius explains, “These new standards are a part of our efforts to help providers and health plans spend less time filling out paperwork and more time seeing their patients.” I’ll be interested to learn more about this identifier and what insurance plans think of it.

August 24, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

5010 Enforcement Delayed by CMS

The Twitterverse is alive with people tweeting about the news that Modern Healthcare broke about CMS deciding to delay enforcement of 5010 until June 2012. Here’s a quote from the article:

The CMS will not begin enforcing the mandated move to Version 5010 transaction standards for an additional three months, until after June 30.

In some ways this is just delaying the inevitable and giving payers a reason to delay their 5010 implementation even more. However, there were likely so many practices that wouldn’t get paid under 5010 and many payers who would be paying using the non-compliant 4010 that this was probably a smart move to delay. For those not that familiar with some of the issues, here’s a good post about how practices should deal with the move from 4010 to 5010. The post highlights the challenge to a practice when some payers are on 5010 and others aren’t yet ready for it.

I’d been hearing a lot of rumblings about the challenges of 5010, so this isn’t that big of a surprise. Although, you can be sure that CMS didn’t want to delay 5010. Particularly since CMS had recently delayed ICD-10 implementation as well. Although, I think fewer people will complain about this 5010 delay compared with those still arguing against the ICD-10 delay.

March 15, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.